Canada Struggles Against Superbug Infections

Though much attention has been paid recently to the growing number of MRSA "superbug" infections in the UK, Canada is having its share of problems with antibiotic-resistant bacterial diseases, too. Treating and preventing the spread of antibiotic-resistant bacteria is reportedly killing at least 8,000 Canadians per year, and costing the health-care system at least C$100 million per year.

Last year in Quebec province, at least 5,000 hospital patients were diagnosed with MRSA, and several died. Hospitals in Montreal and Sherbrooke also battled a deadly strain of Clostridium difficile last year, which caused 109 deaths and was indirectly responsible for 108 additional deaths.

Toronto's Princess Margaret Hospital is also struggling to end an outbreak of C. difficile, from which one patient has died.
[31 March 2005 Update: Ontario's hospital union has called on the Ontario government to establish a mandatory reporting system for hospital-acquired infections -- or the union will set up a phone hotline for patients, family members and hospital staff to report outbreaks of infectious diseases.]

Further east on Prince Edward Island, MRSA infection rates at the QE II Health Sciences Centre have more than doubled since 2002. "In the first nine months of 2004 there were 179 cases at the QE II. The majority were picked up at the hospital," reports CBC News. Dr. Lynn Johnston at QE II says that hospital staff need to take greater care in washing their hands, as that is one of the first lines of defense against spreading infection.

Dr. Michael Rachlis, who studies and writes books about Canada's health-care system, says a big part of the problem is the lack of controls over infection surveillance in hospitals.

"We have become complacent about infectious diseases," he said. "We certainly got reminded in the '80s, with AIDS, that the plagues are always around and threaten us, but in general we are not afraid of germs."

Infection control budgets are still treated like low-hanging fruit, he said, with cleaning and nursing staff the first items to be cut when hospitals experience a financial crunch.

Some Canadian doctors are also blaming the USA as a breeding ground for MRSA germs, which "snowbird" Canadians acquire on their vacations in the States, then bring back to Canada.

“Oh yeah, it’s very, very common for them to come back with MRSA or VRE [vancomycin-resistant enterococcus],” says Dr. Michael Gardam, head of infection control at Toronto’s University Health Network.

“You’ve got to remember: the rates of MRSA or VRE in American hospitals are orders of magnitude higher than Canadian (rates)....Some of our (most significant) VRE and MRSA outbreaks have all been associated with people coming back home with them.”

According to a CBC News investigation, Canada would do well to adopt strict infection-control measures practiced in the Netherlands.

All foreign patients who have been treated at hospitals outside the Netherlands are isolated in private rooms at Dutch hospitals until they can be tested and shown to be free of infections such as MRSA and VRE.

Computer programs carefully track all infected patients and the staff who take care of them.

Peer pressure keeps all nurses and doctors aware of the need to scrub their hands often and discard soiled gloves and gowns, said [Dr. Rob] Diepersloot [the head microbiologist at Deaconess Hospital in Utrecht].

"It only works if everybody is co-operating," he said.

If somebody doesn't co-operate, he has the power to order a room or even a ward closed to patients until a complete sterilization is carried out.

He can even order doctors and other staff to be swabbed and tested for bacteria – and restrict them from working until they are given a clean bill of health.

Antibiotic prescriptions are monitored carefully, and doctors can't use new products until old ones no longer work. That means that antibiotics such as penicillin, which are rarely effective anymore in North America, are still used with good results in Holland.