News

Ontario has recorded its highest number of superbug MRSA cases - a troubling sign that the pernicious invader has made significant inroads in hospitals.

Specifically, the number of cases of methicillin-resistant Staphylococcus aureus has increased by more than 50 per cent over a three-year period, with 16,498 patients infected or colonized with MRSA in 2007, according to figures provided by Ontario's Quality Management Program-Laboratory Services.

By comparison, a total of 10,301 patients were infected or colonized with the superbug in 2004, according to Allison McGeer, director of infection control at Toronto's Mount Sinai Hospital, who analyzed the data for the laboratory services program.

(Being colonized with MRSA means the patients are carriers who are not infected and show no symptoms.)

"These numbers are bad for patients," Dr. McGeer said in a telephone interview. "They are a marker, I think, for how important it is that we really get behind patient safety and infection prevention initiatives in hospitals."

Most patients acquired the superbug in acute-care hospitals, nursing homes and in the community, according to the data.

MRSA can hide inside a nostril, sit on a hand or lurk in a piece of soiled clothing. The damage it inflicts can be minor and treated with a topical antibiotic, or it can be swift and furious, causing blood poisoning, decayed lungs, pneumonia and infected heart valves.

For thousands of patients, it means coming out of hospital far sicker than when they went in.

Michael Gardam, director of infectious diseases, prevention and control for the Ontario Agency for Health Protection and Promotion, said current efforts to combat the problem are not enough. "It speaks to the fact that [the number of cases] are just going to go up every year unless we start really coming up with innovative strategies to try to deal with this," Dr. Gardam said.

Key to preventing MRSA is the thorough cleaning of hospital rooms. Equally important are hand hygiene measures, such as washing with soap or alcohol rubs. Experts say only 40 per cent of health-care providers in Canada properly wash their hands.

The need to encourage health-care workers to wash their hands has prompted flashy poster campaigns and coupon giveaways for doughnuts.

As well, new technology in the form of a beep is being tried out in a special testing room at the E.W. Bickle Centre for Complex Continuing Care, part of Toronto Rehab. There, volunteer staff and volunteers acting as patients wear a small sensor attached to their identification lanyard. In January, real patients are to be moved into that testing room.

Those who approach patients with unsanitized hands will hear a beep, reminding them it is time to clean up. A squeeze of hand gel sanitizer worn in a holster or taken from a wall dispenser, also equipped with a sensor, turns off the sound.

Dick Zoutman, physician director of the Community and Hospital Infection Control Association of Canada, said he found the MRSA figures "deeply disturbing."

"I'm still of the belief, if we had all the right practices in place, human know-how and human technology, we will be able to get the upper hand," Dr. Zoutman said in a telephone interview from Kingston. "But we have to be willing to make that investment."

Also worrisome were figures released on vancomycin-resistant enterocci (VRE), a strain of bacteria that has developed resistance to many commonly used antibiotics, specifically vancomycin.

Figures from Ontario's Quality Management Program-Laboratory Services showed the number of VRE cases climbed from 1,031 in 2004 to 3,900 cases in 2007, according to Dr. McGeer.

"If we can get people to wash their hands, it will make a huge difference," said Phil Hassen, chief executive officer of the Canadian Patient Safety Institute. "This is one where they've got to break the pattern."