CAUTIs cost the NHS a staggering amount each year, regularly leading to antibiotic prescription.
In the growing fight against antibiotic resistance it is key to find novel infection prevention strategies and to dramatically reduce the amount of antibiotics prescribed.
NHS 5 Year Forward Plan
The NHS ‘5 Year Forward Plan’ was devised to set out a clear direction for the NHS, showing why change is needed and how it can be achieved. There are several points in this plan which directly relate to infections prevention, and how this can contribute to an improved NHS.
- Prevention – ensuring people are living healthier lives to prevent the incidence of illness
- Cost-effectiveness – utilising money as efficiently as possible, for example through prevention, new care models and innovative technology. As it stands in current practice the NHS will not have enough money to continue over the next 5 years, lacking around £30 billion; it is crucial to identify prevention methods which can have a net saving
‘A healthcare associated Gram-negative BSI is a positive blood culture for a Gram-negative pathogen in patients who received healthcare in the community or hospital in the previous 28 days’ (Public Health England)
E. coli BSI
Escherichia coli Bloodstream Infections (BSIs) are a major patient safety issue and are set to cost the NHS £2.3 billion by 2018. These contributed to over 5500 NHS patient deaths in 2015 and there is a national initiative which is incentivised to reduce healthcare associated Gram-negative BSIs by 50% across the NHS by 2021. The goals are to: prevent Gram-negative BSIs, prevent the need for antibacterial prescription, to reduce the dose or length or antibiotics as a minimum, and to reduce hospital admissions and HAIs (Hospital Acquired Infections).
E. coli is one of the main pathogens responsible for causing CAUTI, of which Gram-negative CAUTIs are often a source of bacteraemia. E. coli account for 55% of all BSIs, and of these UTIs are responsible for 45% of E. coli BSIs.
E. coli BSIs have increased by 20% over the last five years and the trend is still increasing, which is of grave concern. Furthermore, preventing BSIs should have a huge impact on reducing antimicrobial prescription, which is a key way of reducing the rise in antibiotic resistance. By preventing the run-up to E. coli BSIs, between £900-2400 can be saved per patient.
If we can prevent these E. coli CAUTIs from forming in the first instance, we could be on track with this NHS initiative in reducing E. coli BSI rates. In preventing these infections, we can also reduce antibacterial prescription which we know has a direct correlation to antibiotic resistance.