The report to Ayrshire and Arran Health Board says the infections have risen in both hospitals and community settings
NHS Ayrshire & Arran has recorded rising levels of several key healthcare-associated infections in the first quarter of 2025/26, according to a new report.
The paper highlights the board’s performance against national standards for Clostridioides difficile infection (CDI), Escherichia coli bacteraemia (e-coli), and Staphylococcus aureus bacteraemia (SAB), as well as the management of outbreaks across hospitals and community settings.
Under new Scottish Government standards, NHS Ayrshire & Arran should not exceed 70 healthcare-associated CDI cases, 209 e-coli cases, and 87 SAB cases during the current financial year.
In the first quarter alone, the board recorded 25 CDI cases, already accounting for around 36 per cent of the annual maximum permitted.
The rate of 21.7 per 100,000 occupied bed days is significantly higher than the national figure of 13.9 per 100,000.
More than half of these infections were hospital acquired, with cases appearing across nine wards.
The report also notes an increase in community-associated CDI cases, rising from five in the previous quarter to nine. This represents an 80 per cent jump and places Ayrshire & Arran’s rate at 9.8 per 100,000 population, compared to Scotland’s rate of 5.3.
While performance on healthcare-associated e-coli is more stable, with 47 cases recorded in the quarter—representing 22.5 per cent of the yearly limit—the area remains a national outlier for its community-associated infection rate, having recorded recorded 56 e-coli cases in the community, a rate of 61.1 per 100,000 population, far higher than the Scottish rate of 40.9.
According to national surveillance analysis, this marks the fifth consecutive quarter where the area has been flagged as an exception outlier.
A further breakdown of nearly a decade of cases shows a strong link between community e-coli rates and socio-economic deprivation, with the majority occurring in the most deprived areas.
The board has established a working group to address this issue, including public health teams, community nursing, and pharmacies.
In relation to SAB, Ayrshire & Arran recorded 28 healthcare-associated cases in the first quarter, down from 32 in the previous period.
This reduction reflects a continued downward trend from the peak recorded in 2024, though the current rate of 24.3 per 100,000 occupied bed days remains above the Scottish average of 19.8.
Community-associated SAB cases have fallen to eight, below the national rate, with the report noting ongoing improvements in this area.
The report also covers a series of outbreaks handled by the Infection Prevention & Control Team over the past year.
Covid outbreaks continue to affect services, with 21 outbreaks recorded between July and September 2025 alone.
Other respiratory outbreaks included influenza and Respiratory syncytial virus (RSV). A notable non-respiratory incident involved a scabies outbreak across multiple sites, including Woodland View Hospital, University Hospital Crosshouse, and University Hospital Ayr.
The report attributes contributing factors to staff movement, linen handling issues, and gaps in PPE understanding.
Actions included contact tracing, environmental cleaning, and additional infection control measures.
Across all outbreaks between July and September 2025, four were rated at the most serious “red” level under the national incident assessment tool, with one rated “amber” and 19 on the lowest “green” level.
The report emphasises that all incidents were managed in line with national guidance and that learning from each incident is being shared across services.
Board members heard that achieving the national infection standards will be challenging in the months ahead, particularly given the persistently high rate of community-associated e-coli.
The report states that NHS Ayrshire & Arran is “proactively learning from and improving because of these infection issues,” though several outbreaks remain ongoing and will require continued monitoring and action in the coming quarter.
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