Crisis and opportunities: Reduction of Staphylococcus aureus bacteraemia in the Renal Service.

Crisis and opportunities: Reduction of Staphylococcus aureus bacteraemia in the Renal Service.

Siu Mee Janet Li¹, Jodie Ekholm², Emina Ryan², Melanie-Ann John¹, Michael Maley<sup>1

1</sup>NSW Health Pathology, Sydney, NSW, Australia
²Liverpool Hospital, Sydney, NSW, Australia


Background
The Southwest Sydney Local health District has a surveillance programme of S. aureus bacteraemia (SAB). Data from March 2015- March 2017 showed 24% of SAB were caused by either tunnelled vascular catheter or arteriovenous fistula and prompted an audit at Renal Service across the district in 2017 that revealed average compliance rate to Aseptic non-touch technique (ANTT) was 35% and hand hygiene 72%.

Aim
To reduce the occurrence of SAB by developing an effective and sustainable system for optimal management of vascular access devices for renal patients.

Methods
An interventional team lead by the Cardiovascular Clinical Manager and the Infection Prevention Unit was established to focus on the implementation of the Renal Infection Control Prevention Strategy and Action Plan (ICPS&AP). The Strategies included: Revising procedures and guidelines using evidence based practice; embedding IPC as a core item in all agendas in all Cardiovascular stream and Facility Executive meetings; improving accountability for compliance with hand hygiene and ANTT.

Results
There was a notable reduction in SABs in renal patients since May 2018 with the implementation of the Renal ICP&AP. SAB decreased from 17 (2018) to 4 (2019), 10 (2020) and 7 (2021) and 12 (2022).
ANTT improved to 72% and hand hygiene improved to 88%.

Conclusion
The surveillance programme detected unacceptable rates of SAB and the renal audit highlighted the gap requiring improvement. The ICPS&AP resulted in effective communication and engagement of the leadership essential to formulate an effective strategy which lead to consequent reduced SAB in Renal services.

Biography

Janet Li is a Senior Hospital Scientist who manages the surveillance programme of Staphylococcus aureus bacteraemia at Southwest Sydney Local Health District.