Superbug infections detected outside hospitals

SOME BACTERIA that can successfully resist antibiotics are increasingly being recognised as a problem in healthcare facilities other than hospitals, the Health Service Executive has said.

While numbers of new cases of Clostridium difficileinfection are below levels detected in 2008, the HSE Health Protection Surveillance Centre said expanded monitoring had led to the bacterium being recognised as a problem in the community. Clostridium difficileis a species of bacteria of the genus Clostridium that causes severe diarrhoea and other intestinal disease, sometimes with flu-like symptoms.

Other symptoms include a severe inflammation of the colon, bloating and diarrhoea with abdominal pain, which may become severe. Infections of Clostridium difficileare a common cause of colitis, and in rare cases can progress to toxic megacolon, which can be life-threatening.

The most common risk factors are exposure to antibiotics, advanced age and hospitalisation.

The Health Protection Surveillance Centre (HPSC) has been monitoring new and recurrent cases of Clostridium difficileinfection since 2008 under the category of "acute infectious gastroenteritis". It found numbers of new cases had declined between 2008 and 2010, but unofficial figures in advance of the annual report for 2011 indicate cases have increased by about 10 per cent in the past year.

Since 2009 the monitoring of Clostridium difficileinfection includes data on new and recurrent cases, as well as data on infections in smaller, non-acute community hospitals, hospices, nursing homes and long-term care facilities, as well as cases which occur elsewhere in the community.

The enhanced surveillance enabled a broader recognition of infected sites with the result that it is now seen as an “important cause of infection” in the community.

In December, the HPSC published its annual report on the incidence of notifiable diseases for 2010. This showed cases of Clostridium difficile-associated disease fell by 11 per cent that year with 1,696 cases notified compared with 1,897 cases in 2009, the centre said.

The number of MRSA and HIV infections, as well as certain gastroenteric diseases and healthcare-associated infections, also fell in 2010, according to the annual report. At the end of 2010 MRSA rates in Ireland were at their lowest rates since surveillance began in 1999. The centre found such bloodstream infections also fell by 14 per cent in 2010, with 305 cases notified compared with 355 the previous year.

However, according to unofficial figures released this month, the number of new cases of Clostridium difficilehas risen by about 10 per cent, to about 1,900. These are not expected to be confirmed until the annual report.