IPC General

Healthcare Associated Infections:

Surveillance of the following infections is mandatory in the UK in order to:  

  1. Monitor levels of healthcare associated infection  

  2. Monitor standards of IPC in healthcare

  3. Identify learning

  4. Inform public health actions

  5. Monitor antimicrobial resistance

For this reason the practice may be contacted by the IPC team to obtain details of cases occurring locally.

Escherichia coli (E. coli) bacteria are frequently found in the intestines of humans and animals and form part of the normal gut flora (the bacteria that exist in the bowel).. There are many different types of E. coli, and while some live in the intestine quite harmlessly, others may cause a variety of diseases.

The bacterium is found in faeces and can survive in the environment. E. coli bacteria can cause a range of infections including urinary tract infection, cystitis (infection of the bladder), and intestinal infection. E. coli bacteraemia (blood stream infection) may be caused by primary infections spreading to the blood.

Staphylococcus aureus (S. aureus) is a bacterium that commonly colonises human skin and mucosa without causing any problems. It can also cause disease, particularly if there is an opportunity for the bacteria to enter the body, for example through broken skin or a medical procedure.

If the bacteria enter the body, illnesses which range from mild to life-threatening may then develop. These include skin and wound infections, infected eczema, abscesses or joint infections, infections of the heart valves (endocarditis), pneumonia and bacteraemia (blood stream infection).

Most strains of S. aureus are sensitive to the more commonly used antibiotics, and infections can be effectively treated. Some S. aureus bacteria are more resistant. Those resistant to the antibiotic meticillin are termed meticillin resistant Staphylococcus aureus (MRSA) and often require different types of antibiotic to treat them. Those that are sensitive to meticillin are termed meticillin susceptible Staphylococcus aureus (MSSA). MRSA and MSSA only differ in their degree of antibiotic resistance: other than that there is no real difference between them.

Clostridioides difficile (previously known as Clostridium difficile) is a bacterium that is found in people’s intestines. It can be found in healthy people, where it causes no symptoms (up to 3% of adults and 66% of babies).

C. difficile causes disease when the normal bacteria in the gut are disadvantaged, usually by someone taking antibiotics. This allows C. difficile to grow to unusually high levels. It also allows the toxin that some strains of C. difficile produce to reach levels where it attacks the intestines and causes mild to severe diarrhoea.

C. difficile can lead to more serious infections of the intestines with severe inflammation of the bowel (pseudomembranous colitis). C. difficile is the biggest cause of infectious diarrhoea in hospitalised patients.

You can become infected with C. difficile if you ingest the bacterium (through contact with a contaminated environment or person). People who become infected with C. difficile are usually those who have taken antibiotics, particularly the elderly and people whose immune systems are compromised.

Klebsiella species are a Gram-negative rod shaped bacteria belonging to the Enterobacteriaceae family. They are commonly found in the environment and in the human intestinal tract (where they do not normally cause disease).

These species can cause a range of healthcare-associated infections, including pneumonia, bloodstream infections, wound or surgical site infections and meningitis. Acquired endogenously (from the patient’s own gut flora) or exogenously from the healthcare environment.

Patient to patient spread occurs through contaminated hands of healthcare workers or less commonly by contamination of the environment. Vulnerable patients, like the immune compromised, are most at risk. Infections can be associated with use of invasive devices or medical procedures.

Pseudomonas aeruginosa is a Gram-negative bacterium often found in soil and ground water. P. aeruginosa is an opportunistic pathogen and it rarely affects healthy individuals. It can cause a wide range of infections, particularly in those with a weakened immune system eg cancer patients, newborns and people with severe burns, diabetes mellitus or cystic fibrosis.

P. aeruginosa infections are sometimes associated with contact with contaminated water. In hospitals, the organism can contaminate devices that are left inside the body, such as respiratory equipment and catheters. P. aeruginosa is resistant to many commonly-used antibiotics.

Forms for practices:

BSI GP Case Review Form
HWE PC C.diff Case Review


All of the information contained on this page has been written and compiled by the Hertfordshire and West Essex (HWE) ICS Infection Prevention and Control (IPC) team and is hosted on the HWE Training Hub Website. 

All items and documents on this webpage for IPC are uncontrolled if printed or downloaded. All items on this page are intended for use by Hertfordshire and West Essex GP Practices/Surgeries only.

The HWE ICS Training Hub is not responsible for ensuring that the individual user downloads or accesses the most recent or relevant documents. The responsibility for ensuring that the most recent and relevant information that is accessed rests with the individual. Whilst we endeavour to make sure that all links to current guidance provided in our documents are up to date, please ensure you check online for the latest version. Please contact the IPC team if further information is required, their contact details are: hwe.hcai@nhs.net or 01442 284022.