Health Care Associated Infections

Question Time — Scottish Executive — Health and Wellbeing – in the Scottish Parliament at 2:15 pm on 11 February 2010.

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Photo of Richard Simpson Richard Simpson Labour 2:15, 11 February 2010

To ask the Scottish Executive what discussions it has had with regard to changes in testing for health care associated infections. (S3O-9492)

Photo of Nicola Sturgeon Nicola Sturgeon Scottish National Party

Discussions take place between Scottish Government officials, Health Protection Scotland, the Scottish microbiology forum and the Scottish national clostridium difficile reference laboratory on an on-going basis to ensure that testing for C diff infection reflects best practice and conforms to European recommendations. The chief nursing officer issued new guidance last month on testing for C diff for implementation by all microbiology labs across Scotland.

Photo of Richard Simpson Richard Simpson Labour

On 25 November, following the outbreak in Dundee, I asked about the rapid polymerase chain reaction test that was being used in Dundee for pathogenic C difficile. I am pleased that the new algorithm on C difficile testing now includes PCR. Does the cabinet secretary agree that the standard ELISA test that has previously been used as a screening test is no longer fit for purpose? Can she tell me whether the ELISA test is still the initial screening test for the new algorithm, which is a two-stage test? If that is the case, will she publish the detail of how and why the experts are still of the view that two-stage testing is required, rather than PCR testing alone, as is increasingly the case in the United States? Can she assure me that one of the three available PCR tests will very quickly be in use across Scotland?

Photo of Nicola Sturgeon Nicola Sturgeon Scottish National Party

The ELISA test, as Richard Simpson will know but other members may not, is a biochemical technique used mainly in immunology to detect the presence of an antibody in a sample. As I said, the chief nursing officer issued new guidance last month on the testing for C diff for implementation by all labs. The consensus behind that guidance follows the evaluation report " Clostridium difficile toxin detection assays", which was published in February last year by the NHS Purchasing and Supply Agency. It recognises the shortcomings in current testing methods and recommends a two-step testing algorithm for provisional positives. NHS Scotland has advised the use of testing kits as recommended by the agency in its 2009 report. I am more than happy to enter into more detailed correspondence with Richard Simpson on some of the more technical details of the issue.