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  • Deadly superbug spreads

    Microbe moving out of hospitals into community

    Tom Blackwell
    National Post
    February 5, 2005

    The presence of an antibiotic-resistant superbug in Canadian hospitals has soared more than tenfold in the last decade, causing up to 1,000 deaths annually and costing hospitals $100-million a year, says a new federal report and one of its authors.

    Doctors have long fretted about methicillin-resistant staphylococcus aureus (MRSA), against which most antibiotics are largely impotent. But the report made public this week underlines the extent to which the bacteria has taken hold in hospitals across the country, despite efforts to combat it.

    Meanwhile, there is evidence that MRSA -- chiefly spread within health care facilities now -- is beginning to make its way into the community at large.

    "It's certainly disconcerting," said Dr. Andrew Simor, one of the experts behind the report. "That's a pretty substantial increase ... This is an important superbug."

    Much of the disease, death and expense generated by MRSA is preventable by better infection-fighting measures in hospitals, said Dr. Simor, head of infection control at Toronto's Sunnybrook and Women's College Health Sciences Centre.

    Either a lack of will or government funding restraints often starve specialists like him of the resources needed to battle the microbial invaders, he said. It makes illness and death caused by the microbe a major example of medical error, Dr. Simor said.

    Staphylococcus aureus, or Staph A as it is often known, is a commonly occurring bacteria that can cause minor and serious infections. MRSA is a version of the bug resistant to such widely used antibiotics as methicillin, oxacillin, penicillin and amoxicillin.

    The report issued this week by the Canadian Public Health Agency outlined results of a national surveillance program that tracks the microbe in a sample of 38 hospitals across Canada.

    The prevalence of MRSA -- including both infected people and those carrying it on their skins without getting sick -- jumped from .46 per 1,000 hospital admissions in 1995 to 5.1 in 2003.

    The rate of patients who actually got infections rose more than six-fold to 1.61 per 1,000. That translates into about 1,000 people infected with MRSA in 2003, just at the 38 surveillance hospitals.

    The surveillance program has not tracked deaths from MRSA, but Dr. Simor estimated there are likely 500 to 1,000 total deaths throughout the country annually.

    He and his colleagues worked out a formula two years ago for calculating the cost of MRSA to the health care system. Based on the most recent rates of the bacteria, it would put the price tag currently at $100-million a year.

    "The continued spread of MRSA poses a significant risk to patients and contributes to a substantial financial burden on health care resources," says the report, co-authored by experts from other hospitals and the public health agency.

    "Hospitals should make prevention of the emergence and transmission of antibiotic-resistant organisms and other hospital-acquired infections a patient-safety priority."

    But also of concern is the spread of MRSA away from health care facilities. About 8% of Canadian cases are now in the community, the report said.

    "This has the potential to spill out of the hospitals," Dr. Simor said.

    Vancomycin is the drug of choice to treat MRSA, but it is expensive, tends to have more side effects than other antibiotics and is less effective than others when they are working properly, Dr. Simor said.

    The growing use of the antibiotic has also led to some other bacteria present in hospitals to become resistant to it, he added.

    In the United States, there have been examples of MRSA itself resistant to vancomycin.

    http://www.canada.com/national/natio...5-d60f47f4cd40
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