More deadly infections found in large and teaching hospitals

Kingston, ON – Potentially deadly antibiotic-resistant infections such as C difficile have a higher rate of occurrence in Canada’s large and teaching hospitals, a new national study by Queen’s University shows.

Other super bugs identified in the study are methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE).

"Our findings underscore the need for immediate improvements to infection control measures in many acute care hospitals – particularly in large and teaching facilities where more complicated types of surgery occur," says Dr Dick Zoutman, an epidemiologist at Queen’s, who is also director of infection control services at Kingston General Hospital and co-chair of Ontario’s permanent Provincial Infectious Diseases Committee. Dr Zoutman headed the study.

Also, there is a clear link between the incidence of these antibiotic-resistant organisms and a hospital’s infection tracking and prevention activities, the researchers discovered.

"We now have proof that hospitals which carry out specific infection control prevention activities are more able to control these potentially fatal infections," says Dr Zoutman.

Results of the Health Canada study, co-authored by research associate Douglas Ford of Queen’s Department of Pathology and Molecular Medicine and the Canadian Hospital Epidemiology Committee, will be published in the February 2005 issue of the American Journal of Infection Control (AJIC).

The current research builds on a national survey conducted by Dr Zoutman and Mr Ford that was published in the AJIC in August 2003. The earlier study showed that the majority of Canada’s acute care hospitals fall short of the minimum recommendations for effective infection prevention programs. These shortfalls result in over 200,000 hospital-acquired infections per year in Canada and over 8,000 deaths.

In the new study, participants from the national survey were asked to provide data on the number of occurrences in their facilities of the serious hospital infections C difficile, methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE).

Two key practices were found in hospitals with lower infection rates:

-Active and targeted surveillance to identify and count cases of hospital infections
– Teaching infection control practices to staff who work in hospitals

"Antibiotic-resistant infections are becoming an increasingly significant problem in Canada, and will only get worse if recommended infection control procedures aren’t put into place," says Dr Zoutman. "The bottom line in this study is that if you increase the intensity of infection surveillance and control in hospitals, you can reasonably expect reduced rates of antibiotic-resistant organisms, resulting in decreased costs and fewer deaths."

"Hospital infections are estimated to directly cost our hospitals one billion dollars per year, and this is a low estimate," he continues. "If we implemented fully in our hospitals all of the infection prevention activities that we now know work, we could expect to save 2,400 to 4,000 lives each year from avoidable infections in our hospitals.

"We would also greatly improve wait times and access for care in our overcrowded and very busy hospitals. Investing in hospital infection prevention offers very large rewards," he adds.