Dangerous superbug taking off in Canada, moving beyond high-risk groups

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Dangerous superbug taking off in Canada,

moving beyond high-risk groups

Tue Jun 27, 06:52 PM EST

 

http://ca.news./s/27062006/2/xhealth-dangerous-superbug-taking-canada-m\

oving-beyond-high-risk-groups.html

By Helen Branswell

 

TORONTO (CP) - A dangerous strain of a superbug that can be caught outside

hospital settings has moved beyond the boundaries of the high-risk groups it

first plagued in Canada, causing illness in healthy adults and children in a

number of provinces across the country, researchers reported Tuesday.

 

 

In a series of articles and commentaries rushed to print by the Canadian

Medical Association Journal, they reported on the spread of community-acquired

methicillin-resistant Staphylococcus aureus - known in the medical community as

CA-MRSA.

 

 

The drug-resistant forms of the bug that are spreading in the community -

strains labelled USA300 and USA400 - generally cause hard-to-treat skin and

soft-tissue infections, weeping wounds that will not heal. But they can also

occasionally cause severe illness and even death in previously healthy

individuals.

 

 

" It's sweeping across the nation, no doubt about it, " said Dr. John Conly,

senior author of one of the papers and a leading researcher on the scope of

Canada's problem with community-acquired MRSA.

 

 

" I think this is a pan-Canadian problem. "

 

 

Historically, infections caused by antibiotic-resistant strains of Staph

aureus were transmitted in hospitals, where the heavy use of antibiotics has

allowed a variety of drug-resistant bacteria to flourish.

 

 

But over the past 10 or 15 years, public health authorities in first

Australia and later the United States and Europe reported the troubling

emergence of a

couple of virulent strains of MRSA that seem to have developed in the

community, in people who hadn't been hospitalized.

 

 

Some groups in the community have been known to be at high risk - the

homeless or residents of homeless shelters, intravenous drug users, crack

cocaine

smokers, prison inmates and men who have sex with men. Frequent skin-to-skin

contact, crowding and suboptimal hygiene are believed to facilitate the bugs'

spread.

 

 

But in the United States, where the problem is more advanced than it has been

to date in Canada, infections have been cropping up in day-care centres and

on sports teams, both professional and amateur.

 

 

Conly said U.S. public health authorities estimate the case load runs to the

hundreds of thousands.

 

 

" Washington, Oregon, California and Texas - they've got 15-, 16-year-olds on

ventilators and are seeing really quite devastating pneumonias as a result, "

he said from Calgary, where he teaches medicine at the University of Calgary.

 

 

" So this is really quite a serious issue and I think it's an important one

from a standpoint of Canadian physicians to realize that this is not actually

something south of the border but has swept up from the southwestern United

States and is now sweeping across Canada. "

 

 

Conly, who chairs the Canadian Committee on Antibiotic Resistance, said

Calgary has already seen 300-plus cases of community-acquired MRSA, including

four

or five deaths.

 

 

And while Calgary's outbreak seemed to predate others in the country,

communities in southwestern British Columbia, Saskatchewan, Manitoba and beyond

are

seeing an upswing in cases, he said.

 

 

Dr. Allison McGeer, head of infection control at Toronto's Mount Sinai

Hospital, said the problem is being seen in Canada's largest city as well.

 

 

" Where we used to see none a decade ago and one or two a year starting five

years ago, last year there were probably 12 or 15 (cases), " McGeer said of her

hospital alone.

 

 

" It's beginning to be a regular feature. "

 

Some of the cases are in people from known high-risk groups; but others are

in patients who have no obvious risk of developing CA-MRSA, she noted.

 

In jurisdictions where CA-MRSA has been a problem for a while, the virulent

community strains have started colonizing hospitals, leading to higher rates of

hospital infections and deaths associated with this superbug.

 

McGeer expects this to happen in Canada too, saying the drug-resistant forms

of Staph aureus will drive out the easier-to-treat strains that are

susceptible to more antibiotics.

 

" Eventually it's clear that these strains are going to take over, " she said.

 

A commentary on the issue insisted, though, that it's too soon to throw in

the towel, calling for a concerted effort to combat the spread of the superbug.

 

" Given that MRSA does not respect provincial, territorial or other

jurisdictional boundaries, national collaborative efforts are required, " wrote

Dr. Upton

Allen, an infectious disease expert at Toronto's Hospital for Sick Children.

 

Both Conly and McGeer said it is important for Canadian physicians to

consider CA-MRSA when seeing patients with skin and soft-tissue infections and

to

test the wounds for the presence of drug-resistant microbes, so doctors don't

end

up treating patients with drugs that will have no impact.

 

 

http://ca.news./s/27062006/2/xhealth-dangerous-superbug-taking-canada-m\

oving-beyond-high-risk-groups.html