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Wednesday, 31 August 2011

Superbugs; Germs as an expression of political ideology

MRSA – methicillin resistant staphylococcus aureus
VRE – Vancomycin Resistant entercooccus
The previous blog spoke to the huge initial Canadian success, followed by a near complete collapse of the efforts to contain antimicrobial resistant organisms (AROs). One remnant of the antimicrobial resistance (AMR) surveillance system in Canada that remains is the Canadian Nosocomial Infection Surveillance  Program -  or at least their reports.   MRSA in Canada 2007 , VRE in Canada 2006 .  An effort of multiple hospitals that report identification of certain microbial agents in Canada.  A second effort that focuses on antimicrobial resistant organisms is Safer Healthcare Now – Safer Healthcare Now    A great initiative, albeit focused only on institutional efforts at reducing negative patient outcomes in hospital – not about improving health.   Finally there is a collaborative known as the Canadian Antimicrobial Resistance Alliance (CARA) that was lunched in 2007 and hidden in that site are some data that are not readily recoverable. CAR-A home.  Not surprisingly, the stated audience has a huge emphasis on institutional based services. 
Perhaps you see a trend? the superb efforts focused broadly during the 1996-2006 time period have faded and been replaced by focused hospital based efforts.   Who says politics doesn’t impact health? I’m sure it was merely coincidental that the Conservative government was first elected in 2006, around the time the community based infrastructure began crumbling.  
The last public reports on admission rates for MRSA were from 2003, and rates have gone upwards since with BC reporting that almost 25% of patients admitted to a hospital show evidence of MRSA before requiring hospitalization. The bigger question is why now is it so difficult to find these rates in the public domain? Hospital based (nosocomial) infections are a failure of infection control practices to adequately protect persons needing hospital care from becoming more ill during their hospital stay.  The risk in 2007 for MRSA was just under 1% of persons admitted to hospital, and 0.1% for VRE - and the trends for both were headed upwards. Some provincial data is available, and I would welcome links to others
The only relatively current data that seems locatable at as provincial level is in BC from 2010 BC AMR 2010 report. This appears to be an excellent report and certainly needs replication nationally and within each of the provinces.   (Please send links to other recent data so that it can be shared).

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