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Hospitals should be compelled to post their infection rates, screen patients for superbugs and financially compensate the thousands of Canadians infected in the institutions, patient advocates and experts say.

"The public has the right to know infection rates," said Christine Besson, board secretary of the Association to Defend Victims of Nosocomial Infections.

"It's our taxes, we pay for the hospitals."

Hospitals, she said, should also inform the public about the steps being taken to reduce infections, including screening patients for superbugs such as methicillin-resistant Staphylococcus aureus (MRSA), hand-hygiene audits and other measures.

She is one of several advocates calling for change after stories on the scourge of hospital-acquired infections were published in The Globe and Mail on Saturday.

An estimated 220,000 Canadians develop hospital-acquired infections each year and the number killed by them - more than 8,000 - is roughly the same number who die from breast cancer and road traffic accidents.

Yet, patients are often left in the dark about superbugs as most hospitals in Canada do not publish infection rates.

Compare that to the United States, where 18 states now require hospitals to publish their infection rates. Legislatures in New Jersey and Illinois approved bills, making those states the first to compel hospitals to screen all intensive-care patients for MRSA. In Pennsylvania, a bill requiring MRSA screening of all patients coming from nursing homes was signed in July.

"I think that the return on investment, if you will, will be significant," said Melissa Speck, director of policy development for the Hospital and Healthsystem Association of Pennsylvania.

The Bush administration made a significant policy change when it stated this summer that it will no longer pay the extra costs of treating preventable infections that occur in hospitals, including those resulting from the prolonged use of catheters in blood vessels or the bladder.

Too often, hospital-acquired infections are seen as the "cost of doing the business of medicine," said Betsy McCaughey, foundation and chairwoman of the Committee to Reduce Infection Deaths, a New York-based patient advocacy group.

She said there's a "very close connection between hospital cleanliness and hospital infection rates."

No country is more aware of that than the Netherlands, where a "search and destroy" policy, in effect for the past two decades, has left it with one of the lowest rates of MRSA in the world.

In that country, patients from a hospital abroad - even if it is 10 kilometres from the border - will find themselves immediately isolated and screened for MRSA until screening proves they do not have the superbug.

Those positive for MRSA will be isolated, take disinfecting baths, nasal ointment and oral antibiotics, in an effort to rid them of it, said Paul Bergervoet, an infection control practitioner at the Deventer Hospital in Holland.

Infected patients find there is little recourse. Some are unable to work; others have to pay for costly medication out of pocket.

Ms. Besson of the Montreal-based Association to Defend Victims of Nosocomial Infections said it's "almost impossible to win" a malpractice case because a patient must prove negligence. Laws should be changed, she said, so hospitals are responsible for infections unless they can prove patients acquired them elsewhere.

"It's a chain of care and somewhere in the chain, something wasn't done properly," she said. "The patient ends up a double victim."

Andrew Simor, head of microbiology and infectious diseases at Sunnybrook Health Sciences Centre, estimated the treatment, screening and infection control of MRSA to run $250-million annually.

"The cost in terms of dollars and to the quality of health care is astounding and it's also a little ironic," Dr. Simor said. "Of all of the health-care interventions where you look for cost benefit, this is such an enormous opportunity that has been overlooked."

His study showed it costs an average of $14,360 to treat a patient for MRSA.

Meanwhile, the Public Health Agency of Canada has called for all cases of Clostridium difficile to be reported nationally. However, the agency's recommendation is not binding; only Manitoba and Quebec compel institutions to report MRSA and C. difficile to provincial health bodies.

Starting in January, 2008, the Canadian Council on Health Services Accreditation will compel virtually all acute-care hospitals - in addition to those nursing homes and other institutions seeking a stamp of approval - to provide the rates of MRSA or C. difficile.

The new requirement will compel those organizations to track the rate of either MRSA or C. difficile as part of the accreditation process. Patients will not find themselves enlightened as the figures do not have to be publicly reported.

Ryan Sidorchuk, the Lead of Patients for Patient Safety Canada, a group affiliated with the World Health Organization and funded by the Canadian Patient Safety Institute, said hospitals should disclose the cause of infections directly to patients.

As well, Mr. Sidorchuk gives this advice: "Always ask the health-care provider to wash their hands before laying their hands on you." The same goes for visiting family members and friends, he said.