The Ottawa Hospital is planning to screen every overnight patient for two virulent superbugs in an effort to ward off some of the devastating infections and deaths they cause to thousands of Canadians each year.
About 50,000 patients will be screened for methicillen-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), two intruders that, along with other superbugs, are among the hospital-acquired infections that kill more than 8,000 people across the nation annually.
A summer pilot project at the Ottawa Hospital revealed that patients not considered at high risk of having the superbugs were infected, while others suspected of having them did not, said Virginia Roth, director of infection prevention and control for the hospital.
"We were trying to predict who might be carrying this and testing them," Dr. Roth said in a telephone interview from Ottawa yesterday. "What we're finding is that we're guessing wrong sometimes. You can't always tell who is at high risk of carrying these organisms. We want to make sure that we have nobody slipping through the cracks."
Last year, the Ottawa Hospital had 176 cases of MRSA and 26 cases of VRE, with the vast majority of those cases being carriers or colonized with it. Although Dr. Roth cannot say with certainty that those cases were acquired in her institution, she says they may have been.
Moving to universal screening by late January is believed to make the Ottawa Hospital the second acute-care hospital in Canada to take on such an ambitious screening program. All overnight patients will be tested, except for newborns born in the institution.
Canada's biggest research hospital, the University Health Network in Toronto, rolls out its screening program for the same two superbugs later this month.
And superbug infections have also caught the attention of the federal government. The Public Health Agency of Canada is to develop a plan by January to reduce the country's 220,000 hospital-acquired infections.
For MRSA alone, Canadian hospitals have seen a tenfold increase in the rate of those colonized and infected over the past decade. Some of the highest rates have been noted in Quebec and Ontario, according to the Canadian Nosocomial Infection Surveillance Program study, which looked at MRSA in 38 hospitals in nine provinces.
Ontario is something of an MRSA hot spot: 13,458 patients were found to be colonized or infected with it last year - the highest number the province has ever recorded, according to figures from Ontario's Quality Management Program - Laboratory Services.
MRSA can hide inside a nostril, sit on a hand or lurk in a piece of soiled clothing. It may show up as a blotch of reddened skin, or as a painful, swollen pimple. Its damage can be minor and treated with a topical antibiotic, or it can be merciless, causing blood poisoning, pneumonia and decayed lungs.
The superbug is easily transmitted and thrives in hospitals. For that reason, swab-wielding staff at the University Health Network's three facilities - Princess Margaret, Toronto General and Toronto Western hospitals - will test some 30,000 in-patients each year for MRSA and VRE.
"In terms of the actual in-patient floors, we're right there, right now, in getting people to move to that," said Michael Gardam, the University Health Network's director of infection prevention and control. "It will be phased in over the fall. As soon as a floor is ready to do it, they'll do it."
As part of that screening campaign, about 100 alcohol hand-rub dispensers are to be placed in each UHN hospital ward. They will be placed next to patient beds and outside patient rooms and will dot corridors.
Neurosurgeon Susan Brien, the Canadian Patient Safety Institute's director of operations for Quebec, Eastern Canada and Nunavut, applauded the move by the Ottawa Hospital.
"I think everyone needs to be thinking about screening and collecting information about hospitals," said Dr. Brien, who is attending a patient safety conference in Ottawa.
Yesterday, Dr. Roth said those found to be carriers or infected with MRSA will be isolated, typically in private rooms. Anyone visiting or treating them must don a surgical mask, gown and gloves.