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【科普】报告警示超级病菌(MRSA)快速漫延 专家呼
Experts call for more hospital hand-washing
LISA PRIEST
From Thursday's Globe and Mail
March 27, 2008 at 3:57 AM EDT
A staggering 29,000 Canadian hospital patients acquired the superbug MRSA in a one-year period, including an estimated 2,300 whose deaths were partly attributed to the pernicious bacteria, federal figures released today show.
The increase in methicillin-resistant Staphylococcus aureus translates into 12,000 new infections plus 17,000 patients who became colonized, said Andrew Simor, co-chairman of the Canadian Nosocomial Infection Surveillance Program. (Being colonized with MRSA means the patients are carriers who are not infected and show no symptoms.)
"Hospital infections are a major burden to good medical care," said Dr. Simor, who made the projections based on the just-released 2006 rates from 48 hospitals in nine provinces.
As the modern day scourge of the health-care system, hospital-acquired infections such as MRSA afflict 220,000 Canadians each year. The number who die from them - at least 8,000 - is equal to those killed by car accidents and breast cancer combined.
It's no wonder, then, that the Public Health Agency of Canada has taken on the superbug as a priority.
Howard Njoo, director-general of the agency's Centre for Communicable Diseases and Infection Control, which oversees the group that did the surveillance, said the new figures show MRSA continues to be transmitted in the health-care setting.
In an effort to help stop the spread of MRSA, Dr. Njoo said his agency is working with other groups on several measures, including surveillance, dispersing the best information on how to avoid spreading the infections, educating front-line workers and targeting interventions proven to reduce MRSA. "Infection control practices can be improved, and collectively, we have a responsibility," Dr. Njoo said in a telephone interview from Ottawa yesterday. "And the data there shows we need to do more."
Experts say proper hand hygiene can cut by half the number of hospital-acquired MRSA cases. Yet only 40 per of doctors, nurses and other health-care workers properly wash their hands.
A formidable hospital invader, MRSA can hide inside a nostril, on a hand or in soiled clothing. Symptoms can vary from a blotch of reddened skin - treatable with a topical antibiotic - to blood poisoning, decayed lungs and infected heart valves after what may have begun as an innocuous hospital visit.
Marie-Marthe Becigneul, 48, of Orford in the Eastern Townships of Quebec is a living example of the devastation an MRSA infection can bring.
When she acquired the superbug in 2006 after surviving half a dozen operations for flesh-eating disease, she was rendered a paraplegic. Today, her dream is to be able to walk again.
"You go into hospitals and it's like you see that nobody's washing their hands," Ms. Becigneul said in a telephone interview yesterday.
Ryan Sidorchuk, patient safety advocate for the World Health Organization, called the newly released numbers "concerning" but said he was "happy to see we're taking steps so we do not become as bad as the United States," where the rates are far higher.
And Michael Gardam, director of infection prevention and control for Toronto's University Health Network, said the MRSA rate has "been going up year after year after year and we [Canada] haven't made any concerted effort to try to control this."
Conversely, the University Health Network - which includes the Toronto General, Princess Margaret and Toronto Western hospitals - has made that concerted effort, and for the first time saw a decline in cases as most hospitals are seeing an increase.
Specifically, the network had 129 cases of hospital-acquired MRSA in the 2007 calendar year, compared with 144 cases in 2006, Dr. Gardam said. "It's taken us several years to get to this stage," he said. "... We should have scary rates. We're admitting more than the average amount of MRSA patients, but we're spreading it less."
Installing alcohol hand-rub dispensers, screening all overnight patients for MRSA, ensuring infection control practices are followed and handing out Tim Hortons coupons to those caught in the act of cleansing their hands are some of the network's efforts to drive the rate down.
Dr. Simor, head of microbiology and infectious diseases at Sunnybrook Health Sciences Centre, points out that the infections are not only a burden to patient care, but to the health-care system overall. He estimated the new MRSA infections in 2006 cost Canada's system $200-million to $250-million.
The infection spreads
A 2006 survey of 48 hospitals in nine provinces on newly identified methicillin-resistant Staphylococcus aureus (MRSA) cases for admitted patients shows an increase, especially in Central Canada.
Incidence rate per 1,000 patient admissions
Western: 6.33
Central: 9.86
Eastern: 6.39
Overall: 8.04
*patients infected with MSRA, **asymptomatic carriers who are not infected with MRSA.
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作者:admin@医学,生命科学 2011-02-28 05:14
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