Big hospitals report high infection rate PATIENTS at bigger hospitals are at a disproportionate risk of a bloodstream infection that spreads when infection-control guidelines are not followed. More than 1700 cases of golden staph (Staphylococcus aureus) bloodstream infections were reported by 352 public hospitals in 2011/12, according to a report by the National Health Performance Authority. Of these, 82 per cent of cases were at major hospitals, although they accounted for 64 per cent of bed days. Some forms of golden staph are resistant to antibiotics. Infection of hospital patients is largely preventable through strict hygiene protocols, including hand washing. About 25 per cent of people with a golden staph bloodstream infection die. The worst performing major hospitals include Blacktown (NSW), Goulburn Valley Health (Victoria), Royal Adelaide (South Australia), Westmead (NSW), St George (NSW), John Hunter (NSW) and Prince of Wales (NSW). The best performers include the Prince Charles (Queensland), Mater Adult (Qld) and Royal Hobart (Tasmania). The authority emphasises the results could be distorted by under-reporting by some hospitals and inconsistency in reporting methods. There are large differences in infection rates across similar types of hospital, says Performance Authority CEO Dr Diane Watson. Among major hospitals with more at-risk patients, the rate is four times higher in some hospitals than others. Patients are considered at risk if they are immuno-suppressed or have undergone surgery. These include people admitted for bone marrow transplant, burns, leukaemia and acute renal failure. Dr Watson says the number of infections is small compared with the number of patients that pass through hospitals. However, it remains a serious infection. Every case is considered potentially preventable. The rate of infections is one of the 48 indicators agreed by the Council of Australian Governments to guide the authority's work. The National Healthcare Agreement signed in 2011 sets a target for no more than two cases per 10,000 bed days for each state and territory. For 2011/12 the rate at large hospitals ranges from 0.17 to 2.59 cases per 10,000 bed days. Among major hospitals with more vulnerable patients, there are five hospitals with more than 30 cases and rates of more than two cases per 10,000 bed days. Among major hospitals with fewer vulnerable patients, Blacktown in NSW is the only hospital with a rate of more than two patients per 10,000 bed days. It reports 30 cases and a rate of 2.59 per 10,000 bed days.