• Gram-negative infections continue to rise despite a government drive to halve infections by 2021
  • Community-onset infections driving the increase in infections
  • Many community infections have a link to a recent hospital stay

Bloodstream infections from potentially dangerous bacteria associated with sepsis continue to rise despite the government’s ambition to slash their number, the latest data shows.

There were 10,642 bloodstream infections by the Klebsiella group of gram-negative bacteria diagnosed in the community and hospital last year, up by nearly 3,000 on the year before. Hospital-onset infections alone increased by 10 per cent to 3,182 in 2018-19.

Total infections for E coli, another potentially dangerous gram-negative bug, also increased last year compared with the year before. There were over 43,200 infections overall - up by 5 per cent on last year. This was driven by an increase in community-onset infections, up by 7 per cent to 35,608 compared with the year before.

This comes two years into a government plan to cut gram-negative infections in hospitals in half by 2021.

Community-onset infections from C difficile, a potentially lethal gram-positive bacteria, have also increased, jumping by a fifth from 5,811 in 2017-18 to 7,704 last year. The number of infections in hospitals continued to fall.

However, many patients with community-onset infections may have picked up the bug in hospital, a public health official has warned.

Approximately half of E coli bloodstream infections begin with urinary tract infections and around half the cases will have started in a hospital or the patient will have been in hospital in the past month.

Susan Hopkins, deputy director of Public Health England’s national infection service, told HSJ: “We know that the onset of many [gram-negative bloodstream infections] occur in the community. However, approximately half of the cases will have had a hospital admission in the last month, and therefore a healthcare association should be suspected.”

Hospital and community health providers will therefore need to apply the same interventions “needed to drive down these infections,” Dr Hopkins added. “Along with partners, we are tackling these infections by reducing inappropriate antibiotic prescribing and robust infection prevention and control measures.”