The government yesterday named and shamed hospital trusts where patients were most at risk of catching one of the most feared superbugs as part of a more aggressive campaign to reduce hospital-acquired infections in England.

Huge differences were revealed in the prevalence of MRSA, an infection resistant to a frontline antibiotic, with some hospitals in Somerset and London experiencing rates up to seven times worse than in parts of Yorkshire and Cambridgeshire.

The publication is one way in which the government is trying to force hospitals, doctors and nurses to focus more attention on reducing infections in as many as 100,000 people a year. Of these, an estimated 5,000 die and the overall cost to the NHS might be £1bn a year.

Ministers and officials admit that five years of trying to raise awareness has not brought the desired results. They are planning to publish league tables for other types of infection so that eventually patients can choose hospitals on infection control as well as surgical and medical success rates.

Every trust must have a senior manager responsible for infection control, reporting directly to the chief executive and board. Basic hygiene measures such as handwashing and disinfection will be re-emphasised and there is to be the minimum possible use of catheters, intravenous drips and other tubes. These might provide opportunities for bugs to develop in already seriously ill patients.

There will be another campaign to tell doctors, vets and other health professionals not to misuse antibiotics in either human or animal patients. Over-reliance on the drugs has helped speed up the ability of germs to mutate for self-preservation.

Officials say it is very difficult to establish exactly how many people die from any single infection. MRSA was thought to be a contributory cause to only about 400 deaths in 1998, but overall cases increased from 7,281 in 2001/2 to 7,384 in 2002/3. There were 18,519 infections in the Staphylococcus aureus group, 586 up on the previous year.

Britain has more cases of antibiotic resistance in the commonplace Staphylococcus aureus bugs than many other countries. Its 44% puts it on the same level as Greece, while Denmark and the Netherlands have just 1%. The Dutch screen for MRSA and have far more single rooms in which they can isolate patients until results are available, usually for three days. Few hospitals in England have that kind of accommodation.

Some trusts here do screen patients a few weeks before routine surgery. But Robert Spencer, who chairs the Hospital Infection Society, said: "We do not want these patients treated as lepers. There are antibiotics available. MRSA is not a death knell." Health secretary John Reid says more must be done. "The greatest reason is, of course, the illness and death that result from these infections, but the economic costs are also high, and provide a compelling reason to reduce the number and severity of these infections."

Sir Liam Donaldson, the chief medical officer, said: "We share this problem with other countries but we are determined to be up with the best in tackling it.

The Infection Control Nurses Association said: "With the threat of infections becoming untreatable in the near future due to anti-microbial resistance, it is imperative immediate action is taken."

Tim Yeo, the Conservative health spokesman, called on the government to scrap its separate "ludicrous" system of classing overall hospital cleanliness into green (best), amber, or red (worst) groups, since these bore no relation to their records on MRSA. Many of the worse hospitals for MRSA had green status.

"It remains to be seen if the proposals do not just create more managers in the NHS but deliver where it is really needed - improved practices at ward level," said Mr Yeo.

Peter Walsh, chief executive of the charity Action Against Medical Accidents, said of MRSA: "From what we hear, the infection is so widespread that many hospitals have become almost complacent or resigned to it."

Trusts under scrutiny

The best

Acute NHS trusts with the lowest rates of MRSA per 1,000 bed days for 2002/03:

York Health Services 0.04

Peterborough Hospitals 0.05

Stockport 0.05

Southport & Ormskirk Hospital 0.06

Airedale 0.06

Dudley Group of Hospitals 0.06

Rotherham General Hospitals 0.06

Harrogate Health Care 0.07

Wirral Hospital 0.07

St Helens & Knowsley Hospitals 0.07

South Tyneside Healthcare 0.07

Walsall Hospitals 0.07

Morecambe Bay Hospitals 0.07

The worst

Acute NHS trusts with the highest rates of MRSA per 1,000 bed days for 2002/03:

Lewisham Hospital 0.24

Epsom & St Helier 0.24

Dartford & Gravesham 0.24

Queen Mary's Sidcup 0.25

Countess of Chester Hospital 0.26

East & North Hertfordshire 0.26

West Middlesex University 0.27

Barnet & Chase Farm Hospitals 0.28

Ealing Hospital 0.29

North Middlesex Hospital 0.30

Weston Area Health 0.30

Source: Department of Health