Laboratory confirmed cases of E. colibacteraemia. Data is available by Sub ICB (Integrated Care Board) location.
Rationale
Escherichia coli (E. coli) is a Gram-negative bacterium and has been the predominant cause of bacteraemia in England, Wales, and Northern Ireland, overtaking those caused by S. aureus (a Gram-positive bacterium), since 2003. Following a year-on-year increase in Gram-negative bacteraemia, as reported to PHE via the voluntary surveillance system (44% increase among E. coli bacteraemia alone between 2003 and 2011, from 16,542 to 29,777 voluntary reports), and a recommendation from the government advisory group Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infections to commence E. coli bacteraemia surveillance, the Department of Health mandated NHS acute Trusts to report patient-level data on episodes of E. coli bacteraemia to PHE through the established enhanced mandatory surveillance Data Capture System from June 2011.
Definition of numerator
All cases of E. coli meeting the 'Definition' section above occurring for the past 11 months are summed with the current month to give a rolling 12-month total. For the calculation of rates, the past 11 months are summed with the current month and the denominator is the sum of the bed-days (for trusts) or population (for CCGs) for the current month and preceding 11 months.
The rate for a month is then calculated by dividing the numerator by the denominator and multiplying by 100,000 to give a manageable value.
Definition of denominator
Denominator values are calculated as an annual rolling sum. For any given month, the denominator includes the value for the population for a given geography for that month and the 11 preceding months.
Caveats
These data do not provide a basis for decisions on the clinical effectiveness of infection control interventions in individual Trusts: further investigations considering potential confounders would need to be undertaken before this could be done. Nor do these data provide a basis for comparisons between acute Trust or SICBLs. Rate information, using rate calculations as currently defined, is not appropriate for comparison. The counts of infections have not been adjusted to give a standardised rate considering factors such as organisational demographics or case mix. Rate information is of use for comparison of an individual organisation over time.
‘All reported cases’ refers to all E. coli-positive blood cultures reported by the Trust whose laboratory processes the specimen. It is important to note that this does not necessarily imply that the infection was acquired there. Cases that the UKHSA's HCAI Data Capture System attributes to a commissioning hub (such as the national commissioning hub, 13Q, or one of the regional Health & Justice commissioning hubs) are not featured in sub ICB Location dashboards but they do still contribute to the highest spatial level—the England national total. This means the England case total may be slightly higher than the sum of all sub ICB Location cases.