Sunday, December 04, 2005


Disease resistance is one phenomenon where government controls could theoretically help. But -- suprise! -- it's not happening

A lethal bacterium which surfaces in people being treated with antibiotics is spreading in North America and has grown resistant to drugs, according to two studies published in the New England Journal of Medicine. According to one of the studies, a new, virulent and resistant strain of the bacteria Clostridium difficile broke out in eight US hospital centres between 2000 and 2003.

Provoked by antibiotics inside the intestines of hospital patients, the bacteria showed an ability to mutate and increase its resistance to drugs, the report said. Moreover, the bacteria, which infects the colon causing severe diarrhoea and colitis, a severe inflammation of the intestine, has begun showing up in patients not taking antibiotics or visiting hospitals. Symptoms include watery, malodorous diarrhoea and cramps.

A second study of 1703 patients in 12 hospitals in Quebec, Canada, demonstrated the lethality of the bacteria. Over 13 years the incidence of the bacteria grew fourfold in Quebec, and in 2004 it caused the deaths of 117 people in the first month after they were diagnosed. All of the victims were elderly. "Hospitals need to be conducting surveillance and implementing control measures. And all of us need to realize the risk of antibiotic use may be increasing," warned epidemiologist Clifford McDonald of the US Centres for Disease Control.

Scientists were concerned that Clostridium difficile -- so-named because of the difficulty in detecting it -- had become very resistant to fluoroquinolone antibiotics usually used to treat such infections. "If this epidemic strain continues to spread (...) it will be important either to reconsider the use of fluoroquinolones or to develop other innovative measures for controlling C. difficile-associated disease," said McDonald.



The full extent of Scotland's superbug crisis was spelled out yesterday in a report that showed a fifth of people who die following surgery were infected by bacteria such as MRSA. Latest figures show that of the 1,854 people who died after an operation, 376 of them were infected by a superbug such as methicillin-resistant Staphylococcus aureus (MRSA).

The figures will send a worrying message to the Executive. It has launched a campaign to eradicate such bugs, which cost the NHS in Scotland an estimated œ186 million annually for treatment, extended hospital stays and control of infections. Andy Kerr, the health minister, said last night that the number of surgical deaths from superbugs was "concerning".....

Superbug rates in Scottish hospitals have stayed consistently high since 2001, despite attempts to bring the drug-resistant infections under control. Staphylococcus is a common bacterium that lives harmlessly in the nose or on the skin of about 25-30 per cent of the population. Certain strains have become resistant to conventional antibiotics and collectively have been termed MRSA, or methicillin-resistant Staphylococcus aureus, the superbugs that can prove fatal. Experts have uncovered 17 strains of MRSA, with differing degrees of immunity to antibiotics, although two - clones 15 and 16 - are thought to be responsible for 96 per cent of the infections in the UK.

Symptoms of infection vary depending on where the infection strikes. It may attack surgical wounds, burns, catheter sites, eyes, skin and blood. The risk to hospital patients is greater because wards tend to have a higher concentration of sick, old or weaker people than the general populace, and the environment provides ideal conditions such as communal wards, warm temperatures and shared toilets, for its spread. While rates of MRSA in Scotland are comparable with the rest of the UK, the incidence of the superbug in Britain is among the highest in Europe.....

The SASM report made clear that fewer patients are dying during and after surgery. The report, which reviews all deaths in hospital under the care of a surgeon whether or not an operation has taken place,- shows the number of people who died after being recommended for surgery in Scotland in 2004 was 4,091, compared with 4,478 in 2003. Of the 2004 figure, 1,854 had undergone surgery, while the remainder had died before an operation could be carried out.

Alexandra O'Neil, 57, was admitted to Edinburgh Royal Infirmary in July 1999 after falling down a flight of stairs and shattering her ankle. She died in agony nine months later from the MRSA bacteria, which is believed to have entered her body during a routine operation to place metal pins in her ankle. Mrs O'Neil's family were granted legal aid and are suing Lothian University Hospitals NHS Trust for œ100,000, claiming the hospital was negligent because it failed to prevent the spread of the MRSA infection. Doctors operated on Mrs O'Neil, of Lochend, Edinburgh, several times after they realised she was suffering from MRSA....

Mr Butler said the family had decided to take legal action because they believed the case would force hospitals throughout the UK to take drastic action to improve their levels of cleanliness......

More here


For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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