Quarterly Epidemiological Data on Healthcare Associated Infections

Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland provides quarterly statistics and a combined epidemiological commentary for Clostridioides difficile infection (CDI), Escherichia coli bacteraemia (ECB), Staphylococcus aureus bacteraemia (SAB) and Surgical Site Infection (SSI) in Scotland. Quarterly case numbers and denominator data are provided in order to calculate infection rates and SSI incidence for the 14 regional NHS boards and one Special NHS Board. The full report and relevant documents, including methods and caveats, are available to view at: https://www.nss.nhs.scot/antimicrobial-resistance-and-healthcare-associated-infection/data-and-intelligence/guidance-protocols-and-reports/

Data and Resources

Additional Info

Field Value
Source Case data sources: Electronic Communication of Surveillance in Scotland (ECOSS) and ECOSS Enhanced Surveillance Web Tool Data linkage source: General / Acute Inpatient and Day Case Scottish Morbidity Records (SMR01) Healthcare associated denominator: Total occupied bed days: Information Services Division ISD(S)1 Community associated denominator: National Records of Scotland (NRS) mid-year population estimates Surgical Site Infection cases and procedures: Surgical Site Infection Reporting System (SSIRS)
Author ARHAI Scotland
Maintainer ARHAI Scotland Data and Intelligence Team
Last Updated October 9, 2023, 17:58 (BST)
Created February 5, 2020, 15:12 (GMT)
Contact Address ARHAI Scotland, NHS National Services Scotland, Meridian Court, 4th Floor, 5 Cadogan Street, Glasgow, G2 6QE
Subject Infections in Scotland
Frequency Quarterly
Time frame of data and timeliness The latest iteration of data is three months in arrears upon publication.
Coverage NHS Scotland
Completeness ECB/SAB: Surveillance data are collected using an ECOSS Surveillance Web Tool that allows data collectors in NHS boards to validate ECOSS records as well as add additional cases that may not be included in the ECOSS system. This therefore means that completeness is near to 100%. Only cases reviewed in the enhanced surveillance are included in the 'analysis' in the commentary publication. CDI: Diagnosis of CDI is confirmed in a patient who is both symptomatic with diarrhoea and whose stool has tested positive for toxin using a two-step diagnostic algorithm. Laboratory reports of positive samples are then sent to ECOSS for data extraction. In the community, patients with CDI may have a mild illness that does not require a GP visit, or the symptoms may not be recognised by a GP for a C. difficile test request. In hospitals, the chance of a diarrhoea sample not being tested for C. difficile is much lower, and patients who have ileus (i.e., CDI but with no diarrhoea) might be missed, however as a result of ARHAI Scotland published guidance on managing CDI patients, this is not likely. ARHAI Scotland carries out validation with the NHS boards to check that no CDI cases have been missed from ECOSS each quarter. As with most surveillance programmes, completeness will not be 100% but mandatory surveillance, supported by ARHAI Scotland through issued guidance on diagnosis of CDI and validation of cases, ensures this is as near to 100% as practically possible. When categorising by healthcare or community, not all cases may be successfully data linked in any one quarter therefore could be subject to revision once further information becomes available. SSI: Surveillance coordinators are responsible for completeness and accuracy of data. At hospital level, processes are in placed to ensure all patients included in the standard surveillance have had forms completed (e.g. cross checking with admission or theatre list). ARHAI Scotland also compare SSIRS data with data from ISD to a make sure all procedures under surveillance have been included; however, this comparison is only done annually.
Accuracy CDI, ECB and SAB data are the product of the Electronic Communication of Surveillance in Scotland (ECOSS). Participating laboratories routinely report all identifications of organisms, infection or microbiological intoxication, unless they are known to be of no clinical or public health importance. The collected data is used for; the identification of single cases of severe disease, outbreaks, and longer term trends in the incidence of laboratory reported infections enhanced surveillance, health protection, analytical and statistical use. Delays in SMR01 data availability at the time of report production means that some CDI cases may be reassigned at a later date. Therefore, healthcare-associated and community-associated CDI cases in this report are provisional and may change. The enhanced ECB and SAB ECOSS web tool has built-in validation rules that have to be met before the data is submitted. Further checks of the data are made by ARHAI Scotland before the data are analysed. CDI validation of collected data entails sending a list of CDI cases extracted from ECOSS and asking for confirmation that the cases represent true CDI cases, i.e., meet the case definition which is defined in the surveillance protocol sent to all the NHS boards and available on the ARHAI Scotland website. The final list of CDI cases is then agreed before publishing. SSI data comes from the Surgical Site Infection Reporting System (SSIRS). Complying with a national minimum dataset and definitions for Surgical Site Infections, enables the data submitted to ARHAI Scotland to be mapped into the national dataset following a rigorous quality assurance process. SSIRS has built-in validation rules and data cannot be submitted until rules are met. SSIRS primary validation checks for incomplete or ambiguous core data fields, for example, if presentation to the surgery is ’emergency’ the OPCS code should correspond. Secondary validation includes data checks that can be accepted without completion and/or values that are outside the stated requirements.
Continuity of data Quarterly as at March, June, September, December. Please note data on Surgical Site Infections is not available for 2020, as surveillance of Surgical Site Infection was paused from 2020 Q1 onwards due to COVID-19.
Concepts and definitions Please refer to the methods and caveats document https://www.nss.nhs.scot/publications/quarterly-epidemiological-commentary-for-the-surveillance-of-healthcare-associated-infections-in-scotland-methods-caveats/
Disclosure The PHS protocol on Statistical Disclosure Protocol is followed.
Revision statement These data are not subject to planned major revisions. However, the data collection sources are live databases and may be subject to updates and amendments as further information is submitted by the health boards.
Official statistics designation Official Statistics
Relevance and key uses of the statistics This data is used to produce the Quarterly Epidemiological Commentary for the Surveillance of Healthcare Associated Infections in Scotland. Surveillance data is essential for monitoring trends and assisting in outbreak investigations. The surveillance data should inform and support NHS health boards in controlling and reducing the burden of healthcare associated infections.
Format csv
Language English


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