Superbugs study prompts dialogue on National Infection Control Guidelines

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Sunnybrook researchers lead the first national base-line prevalence study of common antibiotic resistant organisms in Canadian acute-care hospitals.

On any given day superbugs like MRSA and C. difficile affect 1 in 12 Canadian adult patients with most cases being healthcare-acquired, reveals a Sunnybrook-led study, the first national survey of prevalence rates of antibiotic resistant organisms in 176 Canadian acute care hospitals recently published in Infection Control and Hospital Epidemiology.

“Superbugs” or antibiotic resistant organisms such as MRSA (methicillin resistant Staphylococcus aureus), VRE (vancomycin-resistant Enterococci) and CDI (Clostridium difficile infection) result in a substantial burden of disease in hospitals, and costs to the healthcare system.

“This disconcerting finding signals the need for more investigation to manage a major public health concern,” says Dr. Andrew Simor, lead author and chief of Microbiology, and Infectious Diseases at Sunnybrook.

“The results of this study provide a much-needed baseline for national prevalence rates for MRSA, VRE and C. diff. in Canadian hospitals,” says Dr. Simor, a senior scientist at Sunnybrook Research Institute.  “It is our hope the data will inform priority-setting on resources for the control of resistance, and stewardship of antibiotics, and provide the basis for developing more rigorous national infection prevention and control guidelines.”

Sunnybrook researchers reported a total of 2,895 patients who were colonized or infected with MRSA, VRE or CDI.   The researchers also uniquely correlated prevalence rates with certain hospital characteristics and infection prevention and control policies to report:

• significantly lower rates of MRSA and VRE were found in hospitals that routinely used private rooms to accommodate patients either colonized or infected with these organisms

• periods of higher occupancy of beds in a hospital were associated with higher prevalence of CDI

• enhanced environmental cleaning of rooms used for patients with VRE was associated with lower VRE rates.

Participating hospitals were from all ten Canadian provinces and the Northwest Territories representing 65 per cent of eligible hospitals with at least 50 in-patient beds.

The study was done in November 2010. On the survey date, all adult patients were identified by hospital census. Patients colonized (with the organism but without signs or symptoms of infection), and patients infected or symptomatic with the organism were identified.

Data from a similar, follow-up survey conducted in 2012 are currently being analyzed.