MRSA and C. Difficile rates fall (but not here)

A new report from the Chief Medical Officer of Health in England reports that "rates of C. difficile have fallen consistently in all English regions in recent years. MRSA has fallen markedly and is now very low in many areas."

As noted in November, there is no evidence of that in Ontario, as the incidence of both MRSA and C. Difficile is about the same as when public reporting started (i.e. over about the same period as when the rates of MRSA and C. Difficile were falling in England).

While England has made good progress on MRSA and C. Difficile, the new report also indicates an alarming increase in other types of bacteria including new strains of E coli and Klebsiella, which causes pneumonia. There are now many more cases of these than MRSA.

As many as 5,000 patients die each year in the UK of gram negative sepsis – where the bacterium gets into the bloodstream – and in half the cases the bacterium is resistant to drugs, the Guardian reports.

"Antimicrobial resistance poses a catastrophic threat," said Sally Davies, the Chief Medical Officer. "If we don't act now, any one of us could go into hospital in 20 years for minor surgery and die because of an ordinary infection that can't be treated by antibiotics." Davies adds "we will find ourselves in a health system not dissimilar to the early 19th century at some point" if adequate steps are not taken.

The US Centre for Disease Control recently issued a call to action after announcing that an increasingly resistant bacteria has found its way into 18% of U.S. long stay acute care hospitals. The bacteria, called Carbapenem-Resistant Enterobacteriaceae (CRE), kill one in two patients who get bloodstream infections from them and are resistant to all, or nearly all, antibiotics. A resistant form of Klebsiella pneumoniae (which is one type of CRE) has showed a seven-fold increase in the last decade. Prevention techniques include strict hospital cleaning and hand hygiene practices.

Photo: Klebsiella by AJC1

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