Research and analysis

Acquired carbapenemase-producing Gram-negative bacteria in England: October 2020 to June 2023

Updated 17 April 2024

Applies to England

© Crown copyright 2024

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Background

Since 1 October 2020, all diagnostic laboratories in England have a duty to notify the following via the UK Health Security Agency (UKHSA)’s Second Generation Surveillance System (SGSS):

This requirement was launched in conjunction with the national Framework of actions to contain carbapenemase-producing Enterobacterales (CPE), which sets out a range of measures that, if implemented well, will help health and social care providers minimise the impact of CPE.

The analyses below are based on data relating to notifications of confirmed acquired carbapenemase-producing Gram-negative bacteria between 1 October 2020 and 30 June 2023 in England. The data was extracted on 15 August 2023 from both UKHSA’s voluntary surveillance database, SGSS, and the Antimicrobial Resistance and Healthcare-Associated Infections (AMRHAI) Reference Unit database.

Rates of acquired carbapenemase-producing Gram-negative bacteria were calculated using mid-year resident population estimates for the respective year and geography. Geographical analyses were based on the patient’s residential postcode. Where this information was unknown, the postcode of the patient’s GP was used. Failing that, the postcode of the reporting laboratory was used. Cases in England were further assigned to one of 9 local areas, formed from the administrative local authority boundaries.

As patients may have more than one positive specimen taken, specimens taken from the same patient that yielded growth of the same pathogen and carbapenemase within a 52-week period from the initial positive sterile site specimen, screening site specimen or other specimen type (grouped together), were regarded as comprising the same episode and were de-duplicated. Carbapenemase-producing Gram-negative bacteria referred isolates and local laboratory isolates were combined for this de-duplication process, with resistance mechanism results from the AMRHAI Reference Unit retained preferentially where patient specimen overlap occurred. This method differs slightly from the weekly causative agent notification data, where data is not de-duplicated incorporating specimen type. In addition, the data presented in the weekly notification reports utilises SGSS reports only.

The following report summarises trends and geographical distribution of carbapenemase mechanisms identified from Gram-negative bacteria in human samples. Species, mechanism, sample type, and age and sex of patients are also described. For the purposes of this report, quarters are calendar quarters, as such January to March is referred to as ‘Q1’, April to June is referred to as ‘Q2’, July to September is referred to as ‘Q3’ and October to December is referred to as ‘Q4’, alongside relevant years.

Microbiology services

For reference services, including species identification and confirmation of susceptibility testing results, laboratories should contact UKHSA’s AMRHAI Reference Unit in Colindale, London.

Table 1 summarises the carbapenemase gene families that are targeted using the routine polymerase chain reaction (PCR) applied to referred Enterobacterales, Pseudomonas spp. and Acinetobacter spp. that are suspected of harbouring an acquired carbapenemase gene. UKHSA strongly recommends that all diagnostic laboratories are able to detect at least the 4 carbapenemase families in bold (the ‘big 4’) using either PCR or immunochromatographic methods.

Where an ‘exceptional’ carbapenemase and species combination result (cells without a ¥ symbol in Table 1) has been identified, or where an unusual organism has been identified with an acquired carbapenemase (that is, any bacterial genera other than a member of the Enterobacterales, Pseudomonas spp. or Acinetobacter spp.), isolates should be sent to the AMRHAI Reference Unit for confirmation.

Table 1. Distribution of carbapenemase genes covered by AMRHAI Reference Unit molecular assay (based on AMRHAI data) [note 1]

Carbapenemase family Associated with common ‘host’ organism Enterobacterales Associated common ‘host’ organism Pseudomonas spp. Associated with common ‘host’ organism Acinetobacter spp.
KPC ¥ <10D <10D
OXA-48-like ¥ <10D 0
NDM ¥ ¥ ¥
VIM ¥ ¥ <10D
IMP ¥ ¥ ¥
IMI/NMC-A ¥B 0 0
GES ¥ ¥ <10D
FRI <10 0 0
SME <10C ¥ 0 0
DIM 0 <10D 0
GIM <10D <10D 0
SIM 0 <10D 0
SPM 0 <10D 0
OXA-23-like <10D 0 ¥
OXA-40-like 0 0 ¥
OXA-51-likeA 0 0 ¥
OXA-58-like 0 0 ¥

View this table in the data tables file

Notes to Table 1

Note 1. Table 1 uses the following symbols:

¥ = combinations of mechanism and species would not be considered as exceptional results.

A = intrinsic to A. baumannii and only expressed when associated with an insertion element.

B = almost exclusively reported in Enterobacter spp. with less than a handful of reports in other genera.

C = reported only in Serratia marcescens.

D = fewer than 10 in total ever referred to AMRHAI Reference Unit.

Recent developments

Unusual acquired carbapenemase-producing Gram-negative bacteria referred to the AMRHAI Reference Unit in Q2 2023 consisted of 2 VIM-producing Acinetobacter spp. referred from the East and North West of England, one DIM-producing Pseudomonas aeruginosa and a further isolate of Proteus mirabilis positive for the gene encoding an OXA-23-like carbapenemase. All originated from clinically relevant sites rather than colonisations.

Samples from unusual combinations of organism and mechanism should be referred to the AMRHAI Reference Unit for confirmation. Follow-up of such unusual drug/bug combinations has shown that some were due to mixed cultures or reporting errors.

Specimen type

Between October 2020 and June 2023, there were 9,016 acquired carbapenemase-producing Gram-negative bacteria episodes. The majority were identified in screening samples, accounting for 70.3% of carbapenemase notifications, with only 4.9% reported in sterile site specimens (Table 2).

Table 2. Number and percentage of acquired carbapenemase-producing Gram-negative bacterial episodes by specimen type (England): October 2020 to June 2023 [note 2]

Specimen type All reports number All reports percentage [note 4] From AMRHAI number From AMRHAI percentage [note 4]
Sterile site samples 438 4.9 160 10.4
Screening samples 6,335 70.3 733 47.6
Other samples [note 3] 2,243 24.9 648 42.1
All samples 9,016 100.0 1,541 100.0

View this table in the data tables file

Notes to Table 2

Note 2. The AMRHAI Reference Unit actively encourages submission of sterile site isolates for carbapenemase confirmation; the distribution of specimen type will reflect this.

Note 3. Samples that do not fall into either ‘sterile site’ or ‘screening’ samples, for example, urine and lower respiratory tract specimens.

Note 4. The percentages presented in this table are column percentages, with the breakdown of specimen types shown for all reports and AMRHAI reports separately.

The quarterly rate of acquired carbapenemase-producing Gram-negative bacterial episodes between October 2020 and June 2023 is shown in Figure 1.

Although this quarter the rate of carbapenemase-producing Gram-negative bacterial episodes has slightly increased from 1.94 per 100,000 population in Q1 2023 to 2.12 per 100,000 population in Q2 2023, this rise was predominantly due to increases among screening samples, with the number of sterile site isolates remaining relatively stable (Figure 1). Most of this increase appears to correlate with increased detection relating to screening following localised hospital outbreaks.

Quarterly changes in rate of episodes may reflect an uptick in screening following changes to screening policy rather than an actual increase in incidence. Furthermore, as there are only 11 quarters of notification data, it is too early to conclude that there may be any seasonality, particularly in light of the COVID-19 pandemic, where quarterly changes may be affected by COVID-19 ‘waves’ seen during this period or associated with local carbapenemase-producing Gram-negative bacteria outbreaks.

The remaining data summaries in this report consider all samples grouped together.

Figure 1. Rate of acquired carbapenemase-producing Gram-negative bacteria episodes by specimen type and quarter (England): October 2020 to June 2023

Geographic distribution

The rate of acquired carbapenemase-producing Gram-negative bacterial episodes varied by Office for National Statistics (ONS) region (Figure 2), with the highest overall rate between July 2022 and June 2023 reported in the North West (2.01 episodes per 100,000 population), followed by the London region (1.68 episodes per 100,000 population). The lowest incidence across the last year was reported in the East of England and South West regions (0.22 and 0.14 episodes per 100,000 population, respectively).

Figure 2. Geographical distribution of acquired carbapenemase-producing Gram negative bacterial incidence rates per 100,000 population (England): July 2022 to June 2023 [note 5]

Contains OS data © Crown copyright and database right 2018

Notes to Figure 2

Note 5. The region geography is based on the laboratory location and linked to the ONS data for regions.

The rate of acquired carbapenemase-producing Gram-negative bacterial episodes for each ONS region by calendar quarter is shown in Table 3.

The rate of bacterial episodes in all ONS regions increased from Q1 2023 to Q2 2023 in all regions except East Midlands, North East and Yorkshire and The Humber. A large increase was noted in West Midlands, where the rate increased from 2.22 to 3.31 per 100,000 population. The increase in West Midlands was only seen in screening samples. The largest decrease was noted in the North East, where the bacterial episode rate decreased from 2.04 in Q1 2023 to 1.25 episodes per 100,000 population in Q2 2023.

Table 3. Rate per 100,000 population of acquired carbapenemase-producing Gram-negative bacterial episodes by ONS region (England): July 2022 to June 2023

ONS region Q3 2022 number Q3 2022 rate Q4 2022 number Q4 2022 rate Q1 2023 number Q1 2023 rate Q2 2023 number Q2 2023 rate
East Midlands 128 2.62 66 1.35 48 0.98 43 0.88
East of England 33 0.52 32 0.50 25 0.39 33 0.52
London 275 3.13 283 3.22 384 4.37 388 4.41
North East 45 1.70 35 1.32 54 2.04 33 1.25
North West 347 4.68 346 4.66 306 4.12 345 4.65
South East 49 0.53 64 0.69 60 0.65 69 0.74
South West 19 0.33 21 0.37 16 0.28 17 0.30
West Midlands 119 2.00 168 2.82 132 2.22 197 3.31
Yorkshire and The Humber 106 1.93 92 1.68 74 1.35 73 1.33

View this table in the data tables file

Geographical differences in carbapenemase family

Between July 2022 and June 2023, the most common carbapenemase families reported across all regions were OXA-48-like (35.3%), NDM (31.7%), and KPC (24.9%). However, similarly to the incidence of episodes, the distribution of carbapenemase families identified also varied regionally (Figure 3).

In the North West, which had the highest incidence rate, the most common carbapenemase families identified were KPC (51.8%) and OXA-48-like (27.5%). KPC was not as common in any of the other regions, accounting for fewer than 32.3% of episodes in each region. For example, in London, which also had a high overall incidence rate, KPC accounted for 4.9% of episodes with NDM and OXA-48-like carbapenemases dominating (48.2% and 36.8%, respectively).

Another regional difference was observed in the North East and South West, where IMP was more common compared to any of the other regions, accounting for 19.2% and 16.4% of episodes, respectively (other regions reporting fewer than 8.1%). However, given the small number of carbapenemases reported in some regions, the diversity of carbapenemases reported is likely to be strongly impacted by individual outbreaks. In the 2 regions that had the lowest incidence rates, the most common carbapenemase family was OXA-48-like (63.9% in the East of England and 35.6% in the South West, respectively).

The distribution of carbapenemase families within each ONS region also varied by quarter. For example, the most common carbapenemase family identified in the South West was predominantly OXA-48-like in Q2 2023 but in Q3 2022 it was predominantly NDM. However, for both quarters the majority were identified in screening samples.

Figure 3. Geographical distribution of acquired carbapenemase-producing Gram-negative bacterial episodes by carbapenemase family (England): July 2022 to June 2023

Notes to Figure 3

Note 6. Other carbapenemase families include DIM, GES, GIM, IMI, OXA-23 and SME.

Distribution of species and carbapenemase family

Between July 2022 and June 2023, the most frequently isolated Gram-negative bacterial species with a confirmed acquired carbapenemase was Escherichia coli, accounting for 34.1% of all specimens. This was followed by Klebsiella pneumoniae, and Enterobacter spp., which accounted for 32.6% and 16.1% of all specimens, respectively (Table 4).

The carbapenemase family most frequently identified in E. coli and K. pneumoniae isolates was OXA-48-like (40.7% and 37.7%, respectively) and in Enterobacter spp. isolates was NDM (33.3%). In E. coli and K. pneumoniae isolates, this was followed by NDM and KPC carbapenemase families (38.7% and 17.7% in E. coli, and 30.6% and 27.5% in K. pneumoniae, respectively), and in Enterobacter spp. this was followed by KPC (26.5%) and OXA-48-like (24.0%) carbapenemase families.

Aside from the ‘big 5’ carbapenemase families (KPC, OXA-48-like, NDM, VIM and IMP), the AMRHAI Reference Unit also screens for rarer carbapenemase families, and it is recommended that all isolates suspected to produce a carbapenemase but negative for the ‘big 5’ carbapenemase families are referred to the AMRHAI Reference Unit for further screening. Between October 2020 and June 2023, DIM, GES, GIM, IMI, OXA-23 and SME carbapenemases were identified in small numbers (1, 26, 2, 23, 5 and 2, respectively), with only one isolate (GIM positive) being identified from an invasive specimen.

Table 4. Acquired carbapenemase-producing Gram-negative bacterial episodes by species and carbapenemase family (England): July 2022 to June 2023

Species IMP number IMP % KPC number KPC % NDM number NDM % OXA-48-like number OXA-48-like % VIM number VIM % Other number Other % Total number % of Total per species
Acinetobacter spp. [note 7] 13 22.8 2 3.5 35 61.4 4 7.0 3 5.3 0 0.0 57 1.3
Citrobacter spp. 12 5.2 56 24.5 46 20.1 105 45.9 10 4.4 0 0.0 229 5.1
Enterobacter spp. 89 12.2 193 26.5 243 33.3 175 24.0 20 2.7 9 1.2 729 16.1
Escherichia coli 23 1.5 274 17.7 598 38.7 629 40.7 20 1.3 0 0.0 1,544 34.1
Other Escherichia spp. 0 0.0 5 45.5 4 36.4 2 18.2 0 0.0 0 0.0 11 0.2
Klebsiella oxytoca 5 3.7 83 61.5 11 8.1 33 24.4 3 2.2 0 0.0 135 3.0
Klebsiella pneumoniae 33 2.2 453 30.6 407 27.5 557 37.7 28 1.9 1 0.1 1,479 32.6
Other Klebsiella spp. 0 0.0 16 20.3 20 25.3 39 49.4 4 5.1 0 0.0 79 1.7
Morganella spp. 0 0.0 0 0.0 4 36.4 7 63.6 0 0.0 0 0.0 11 0.2
Pseudomonas aeruginosa [note 7] 21 18.4 7 6.1 35 30.7 6 5.3 37 32.5 8 7.0 114 2.5
Other Pseudomonas spp. [note 7] 2 12.5 1 6.3 4 25.0 1 6.3 7 43.8 1 6.3 16 0.4
Serratia spp. 0 0.0 1 6.3 3 18.8 9 56.3 1 6.3 2 12.5 16 0.4
Other Enterobacterales [note 8] 1 1.0 36 34.3 28 26.7 32 30.5 6 5.7 2 1.9 105 2.3
Other Gram-negative bacteria [note 9] 2 40.0 1 20.0 2 40.0 0 0.0 0 0.0 0 0.0 5 0.1
Total 201 4.4 1,128 24.9 1,440 31.8 1,599 35.3 139 3.1 23 0.5 4,530 100.0

View this table in the data tables file

Notes to Table 4

Note 7. KPC and OXA-48-like in Pseudomonas spp. and OXA-48-like in Acinetobacter spp. are extremely rare, and results should be interpreted with caution. The numbers reported here have not been confirmed by the AMRHAI Reference Unit and laboratories identifying these unusual combinations should be referring such isolates to AMRHAI.

Note 8. Includes coliform, Cronobacter spp., Hafnia spp., Kluyvera spp., Leclercia adecarboxylata, Lelliottia amnigena, Mixta calida, Pantoea spp., Phytobacter ursingii, Pluralibacter gergoviae, Proteus spp., Providencia spp., Raoultella spp., and Shigella spp.

Note 9. The numbers reported here have not been confirmed by the AMRHAI Reference Unit and laboratories identifying these unusual combinations should be referring such isolates to AMRHAI.

Age and sex distribution

Between July 2022 and June 2023, the rate of acquired carbapenemase-producing Gram-negative bacterial episodes was highest among the oldest and youngest members of the population. A similar age pattern was noted for both sexes, although overall the rate was higher in males compared to females (overall rates of 9.1 and 6.8 episodes per 100,000 population, respectively: Figure 4). This aligns with the age group and sex distribution noted in previously published reports on Gram-negative bacteraemia such as E. coli, Klebsiella spp., P. aeruginosa and Enterobacter spp.

Figure 4. Rate [note 10] of acquired carbapenemase-producing Gram-negative bacterial episodes per 100,000 population by age and sex [note 11] (England): July 2022 to June 2023

Notes to Figure 4

Note 10. Rates have been calculated using cumulative reports across all 10 quarters of reporting, and as such cannot be compared to previous quarters (1).

Note 11. Information about patient sex is only recorded in 99.1% of cases.

Figure 4 shows the acquired carbapenemase-producing Gram-negative bacterial incidence rates by age group between July 2022 to June 2023, with the highest rate reported in those 85 years and over (45.3 per 100,000 population) followed by those aged 75 to 84 years (28.8 per 100,000 population). The overall rate of confirmed carbapenemases was 11.6 per 100,000 population in infants less than one year old.

Quarterly mandatory laboratory return reporting (July 2022 to June 2023)

Table 5. Quarterly mandatory laboratory returns (QMLR) for the total number of rectal swabs and faecal screening specimens taken for CPE screening by acute trust type [note 12] (England): July 2022 to June 2023

Trust type [note 12] Q3 2022 reported screens (%) Q3 2022 total number screens Q4 2022 reported screens (%) Q4 2022 total number screens Q1 2023 reported screens (%) Q1 2023 total number screens Q2 2023 reported screens (%) Q2 2023 total number screens
Small (n=22) 13 (59.1) 3,910 15 (68.2) 4,596 14 (63.6) 6,813 14 (63.6) 6,119
Medium (n=21) 18 (85.7) 5,200 18 (85.7) 4,494 18 (85.7) 5,725 18 (85.7) 6,216
Large (n=24) 21 (87.5) 13,670 21 (87.5) 14,040 19 (79.2) 11,980 18 (75.0) 11,811
Multi-service (n=7) 7 (100.0) 2,116 7 (100.0) 1,887 7 (100.0) 2,219 6 (85.7) 2,148
Specialist (n=16) 10 (62.5) 4,267 10 (62.5) 4,220 9 (56.3) 3,845 9 (56.3) 4,113
Teaching (n=47) 39 (83.0) 88,994 38 (80.9) 75,420 34 (72.3) 59,020 32 (68.1) 60,266
Total 108 (78.8) 118,157 109 (79.6) 104,657 101 (73.7) 89,602 97 (70.8) 90,673

View this table in the data tables file

Notes to Table 5

Note 12. Trust type obtained through NHS Digital Estate Return Information Collection (ERIC).

Reporting of quarterly totals of rectal swabs and faecal specimens taken for CPE screening was added to the mandatory QMLR section of the HCAI DCS in October 2019, and reporting became mandatory in October 2020. Between July 2022 and June 2023, there were 403,089 screens reported by 115 NHS trusts leading to an overall trust reporting rate of 83.9% (Table 5). This means that across the 4 quarters, there were 133 instances where an NHS trust did not submit a return. Of the acute trusts that reported screening data, 3.6% reported that they conducted zero screens.

Between July 2022 and June 2023, the number of trusts that reported screens was stable, ranging from 70.8% to 79.6%. Screening was more predominant in the acute teaching trusts, accounting for 70.4% of screening swabs taken during this time period. By reporting acute trust, the total screens reported for the quarter ranged from 0 to 20,088. The full list of reporting, including those that did not submit a return, is available in the appendix by individual NHS acute trust.

Reference

  1. UKHSA (2023). Quarterly laboratory surveillance of acquired carbapenemase-producing Gram-negative bacteria in England: October 2020 to December 2022 [appendix corrected]

Appendix

Appendix Table 1. QMLR returns for the total number of rectal swabs and faecal screening specimens taken for CPE screening by acute trust (England): July 2022 to June 2023

Trust name Trust type Q3 2022 Q4 2022 Q1 2023 Q2 2023
Airedale NHS Foundation Trust Small 88 125 2,161 327
Alder Hey Children’s NHS Foundation Trust Specialist 1,143 1,193 1,210 1,256
Ashford and St Peter’s Hospitals NHS Foundation Trust Medium 265 461 257 228
Barking, Havering and Redbridge University Hospitals NHS Trust Teaching 1,185 1,158 1,171 1,322
Barnsley Hospital NHS Foundation Trust Small 38 30 43 228
Barts Health NHS Trust Teaching 3,109 3,252 3,143 3,706
Bedfordshire Hospitals NHS Foundation Trust Medium 125 161 109 112
Birmingham Women’s and Children’s NHS Foundation Trust Specialist        
Blackpool Teaching Hospitals NHS Foundation Trust Teaching 759 853 753 853
Bolton NHS Foundation Trust Medium 342 339 358 697
Bradford Teaching Hospitals NHS Foundation Trust Teaching 2,252 2,311 2,161 2,403
Buckinghamshire Healthcare NHS Trust Multi-service 396 407 315 473
Calderdale and Huddersfield NHS Foundation Trust Large 217 225 272 482
Cambridge University Hospitals NHS Foundation Trust Teaching 1,627 1,815 1,719 1,876
Chelsea and Westminster Hospital NHS Foundation Trust Teaching        
Chesterfield Royal Hospital NHS Foundation Trust Small        
Countess of Chester Hospital NHS Foundation Trust Small        
County Durham and Darlington NHS Foundation Trust Multi-service 475 162 161 126
Croydon Health Services NHS Trust Medium 400 272 493 119
Dartford and Gravesham NHS Trust Small 309 217 263 230
Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust Teaching 177 193 222 304
Dorset County Hospital NHS Foundation Trust Small 13 3 92 184
East and North Hertfordshire NHS Trust Large 1,494 1,530 1,144 1,252
East Cheshire NHS Trust Small        
East Kent Hospitals University NHS Foundation Trust Teaching 426 312 328 462
East Lancashire Hospitals NHS Trust Large 411 549 351 509
East Suffolk and North Essex NHS Foundation Trust Large        
East Sussex Healthcare NHS Trust Large 341 299 299 238
Epsom and St Helier University Hospitals NHS Trust Teaching 288 246 277 265
Frimley Health NHS Foundation Trust Large 745 757 679 793
Gateshead Health NHS Foundation Trust Medium 22 15 55  
George Eliot Hospital NHS Trust Small   254   213
Gloucestershire Hospitals NHS Foundation Trust Large 103 100 129 131
Great Ormond Street Hospital For Children NHS Foundation Trust Specialist 1,604 1,577 1,747 1,715
Great Western Hospitals NHS Foundation Trust Medium 114 151 147 186
Guy’s and St Thomas’ NHS Foundation Trust Teaching 433 492    
Hampshire Hospitals NHS Foundation Trust Large 288 333 380 258
Harrogate and District NHS Foundation Trust Small   84 109 101
Homerton Healthcare NHS Foundation Trust Teaching 875 844 854 892
Hull University Teaching Hospitals NHS Trust Teaching 309 209 211 219
Imperial College Healthcare NHS Trust Teaching 20,088 19,472 18,424 17,909
Isle of Wight NHS Trust Multi-service 30 52 35 44
James Paget University Hospitals NHS Foundation Trust Teaching 29 33    
Kettering General Hospital NHS Foundation Trust Small 316 259 238 316
King’s College Hospital NHS Foundation Trust Teaching 10,622 9,679    
Kingston Hospital NHS Foundation Trust Medium 113 88 100 257
Lancashire Teaching Hospitals NHS Foundation Trust Teaching 501 591 596 826
Leeds Teaching Hospitals NHS Trust Teaching 4,690 58 6,322 5,040
Lewisham and Greenwich NHS Trust Large 1,572 1,572 829 785
Liverpool Heart and Chest Hospital NHS Foundation Trust Specialist        
Liverpool University Hospitals NHS Foundation Trust Teaching        
Liverpool Women’s NHS Foundation Trust Specialist        
London North West University Healthcare NHS Trust Teaching 730 1,040 734 1,863
Maidstone and Tunbridge Wells NHS Trust Large 314 297 293 311
Manchester University NHS Foundation Trust Teaching        
Medway NHS Foundation Trust Medium        
Mid and South Essex NHS Foundation Trust Large        
Mid Cheshire Hospitals NHS Foundation Trust Small        
Mid Yorkshire Hospitals NHS Trust Large 134 137 95 136
Milton Keynes University Hospital NHS Foundation Trust Teaching        
Moorfields Eye Hospital NHS Foundation Trust Specialist 0 0 0 0
Norfolk and Norwich University Hospitals NHS Foundation Trust Teaching 542 604 524 523
North Bristol NHS Trust Large 112 85    
North Cumbria Integrated Care NHS Foundation Trust Small 1,077 1,057 1,030 1,163
North Middlesex University Hospital NHS Trust Teaching        
North Tees and Hartlepool NHS Foundation Trust Medium 306 285 284 290
North West Anglia NHS Foundation Trust Large 168 172 151 207
Northampton General Hospital NHS Trust Medium       662
Northern Care Alliance NHS Foundation Trust Teaching 801 859 804 894
Northern Lincolnshire and Goole NHS Foundation Trust Medium 25 31 52 184
Northumbria Healthcare NHS Foundation Trust Large 195 218 185 225
Nottingham University Hospitals NHS Trust Teaching 2,030 1,527 1,732 1,696
Oxford University Hospitals NHS Foundation Trust Teaching 1,690 1,824 1,781 2,002
Portsmouth Hospitals University National Health Service Trust Large 221 268 246 264
Queen Victoria Hospital NHS Foundation Trust Specialist 0 0 0 6
Royal Berkshire NHS Foundation Trust Large 1,895 1,994 1,497 2,514
Royal Cornwall Hospitals NHS Trust Large 122 174 202 224
Royal Devon University Healthcare NHS Foundation Trust Large 366 258 192 330
Royal Free London NHS Foundation Trust Teaching 8,451      
Royal National Orthopaedic Hospital NHS Trust Specialist 136 255 189 201
Royal Papworth Hospital NHS Foundation Trust Specialist 48 75 99 44
Royal Surrey County Hospital NHS Foundation Trust Medium 1,177 1,162 1,209 1,249
Royal United Hospitals Bath NHS Foundation Trust Medium 110 160 303 548
Salisbury NHS Foundation Trust Small 111 113 144 188
Sandwell and West Birmingham Hospitals NHS Trust Large 0 0    
Sheffield Children’s NHS Foundation Trust Specialist 79 54 111 86
Sheffield Teaching Hospitals NHS Foundation Trust Teaching 1,212 1,135 1,127 1,138
Sherwood Forest Hospitals NHS Foundation Trust Medium        
Somerset NHS Foundation Trust Multi-service 826 853 854 1,450
South Tees Hospitals NHS Foundation Trust Teaching 265 260 288 466
South Tyneside and Sunderland NHS Foundation Trust Large        
South Warwickshire University NHS Foundation Trust Medium 309 405 533 638
Southport and Ormskirk Hospital NHS Trust Small        
St George’s University Hospitals NHS Foundation Trust Teaching 1,521 1,476 988 1,176
St Helens and Knowsley Teaching Hospitals NHS Trust Teaching 1,580 1,491 1,274 1,634
Stockport NHS Foundation Trust Medium 465 420 388 427
Surrey and Sussex Healthcare NHS Trust Medium 167 177 252 265
Tameside and Glossop Integrated Care NHS Foundation Trust Small 153 182 192  
The Christie NHS Foundation Trust Specialist       393
The Clatterbridge Cancer Centre NHS Foundation Trust Specialist        
The Dudley Group NHS Foundation Trust Medium 86 24 40 39
The Hillingdon Hospitals NHS Foundation Trust Small        
The Newcastle Upon Tyne Hospitals NHS Foundation Trust Teaching 666 539 670 1,001
The Princess Alexandra Hospital NHS Trust Small 265 250 232 254
The Queen Elizabeth Hospital, King’s Lynn, NHS Foundation Trust Small 220 211 219 203
The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust Specialist 44 27 104  
The Rotherham NHS Foundation Trust Small 1 1 16 26
The Royal Marsden NHS Foundation Trust Specialist 913 691    
The Royal Orthopaedic Hospital NHS Foundation Trust Specialist 300 348 385 412
The Royal Wolverhampton NHS Trust Large 1,847 2,401 2,219 2,525
The Shrewsbury and Telford Hospital NHS Trust Medium 107 116 114 104
The Walton Centre NHS Foundation Trust Specialist        
Torbay and South Devon NHS Foundation Trust Multi-service 13 8 1 8
United Lincolnshire Hospitals NHS Trust Large 950 597 743 627
University College London Hospitals NHS Foundation Trust Teaching 967 902 957 950
University Hospital Southampton NHS Foundation Trust Teaching 553 574 647 1,290
University Hospitals Birmingham NHS Foundation Trust Teaching        
University Hospitals Bristol and Weston NHS Foundation Trust Teaching     0  
University Hospitals Coventry and Warwickshire NHS Trust Teaching 1,058 1,200 1,146  
University Hospitals Dorset NHS Foundation Trust Teaching   229 170 224
University Hospitals of Derby and Burton NHS Foundation Trust Teaching 256     227
University Hospitals of Leicester NHS Trust Teaching 7,352 8,011 8,018 7,911
University Hospitals of Morecambe Bay NHS Foundation Trust Teaching 195 127 204 232
University Hospitals of North Midlands NHS Trust Teaching 8,893 8,988    
University Hospitals Plymouth NHS Trust Teaching 473 808 919  
University Hospitals Sussex NHS Foundation Trust Teaching 542 487 526 483
Walsall Healthcare NHS Trust Small 836 873 991 1,513
Warrington and Halton Teaching Hospitals NHS Foundation Trust Teaching 334 290 272 388
West Hertfordshire Teaching Hospitals NHS Trust Medium 825 0 836 0
West Suffolk NHS Foundation Trust Small        
Whittington Health NHS Trust Multi-service 64 79 543  
Wirral University Teaching Hospital NHS Foundation Trust Teaching 1,457 1,486    
Worcestershire Acute Hospitals NHS Trust Large 2,175 2,074 2,074  
Wrightington, Wigan and Leigh NHS Foundation Trust Medium 242 227 195 211
Wye Valley NHS Trust Multi-service 312 326 310 47
Yeovil District Hospital NHS Foundation Trust Small 483 937 1,083 1,173
York and Scarborough Teaching Hospitals NHS Foundation Trust Teaching 56 45 58 91

View this table in the data tables file

Acknowledgements

These reports would not be possible without the weekly contributions from microbiology colleagues in laboratories across England. The support from colleagues within UKHSA, and the AMRHAI Reference Unit in particular, is valued in the preparation of the report. Feedback and specific queries about this report are welcome via hcai.amrdepartment@ukhsa.gov.uk

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