Letter to the Editor: Could a “Super Bug” be the cause of some deaths at PMH?

Dear Editor,

Recently in the news we have read about the “passing” of a few persons who were patients at the Princess Margaret Hospital. Whilst the causes of death published could in fact be the real reason of those deaths; I have a concern here and that is MRSA or “The Super Bug” as it’s sometimes called is or have been or could be one of the many reasons for some of those untimely deaths of some of these patients.

“Methicillin-resistant Staphylococcus Aureus (MRSA) is a type of staph bacteria that is resistant to certain antibiotics called beta-lactams. These antibiotics include methicillin and other more common antibiotics such as oxacillin, penicillin, and amoxicillin. In the community, most MRSA infections are skin infections. More severe or potentially life-threatening MRSA infections occur most frequently among patients in healthcare settings. While 25% to 30% of people are colonized* in the nose with staph, less than 2% are colonized with MRSA (Gorwitz RJ et al. Journal of Infectious Diseases. 2008:197:1226-34.)”

*Colonized:

When a person carries the organism/bacteria but shows no clinical signs or symptoms of infection. For Staph aureus the most common body site colonized is the nose.

Nursing staff may not be aware of it at the time and just go with an explanation of whatever the patients condition is at the time. Having worked in such an environment in a foreign country for many years; it is cause for concern these sudden vaguely explained deaths. Medical staff tend to just give obvious reasons and never look further. Nurses may give the patient an antibiotic that could escalate the spread of the bacteria. I do not wish to give the impression that the nursing and medical hygiene practices at the PMH is anything less than thorough; but as human beings we tend to get comfortable in our environments and not be aware of our transmitting of the bacteria or that we should maintain the highest care standards as possible at all time.

I would hope that the Medical Board and Ministry of Health would revisit this area and check because this “super bug” can be the cause of the increase in patients untimely deaths at the PMH and not the operation they did. They could have an allergic reaction to some of those medication that is supposed to also help fight this bug.

You go in to hospital most times without this bug and leave with it. And it’s most prevalent in the older patients.

“Symptoms of MRSA

As with all regular staph infections, recognizing the signs and receiving treatment for MRSA skin infections in the early stages reduces the chances of the infection becoming severe.

Severe Infections

MRSA in healthcare settings usually causes more severe and potentially life-threatening infections, such as bloodstream infections, surgical site infections, or pneumonia. The signs and symptoms will vary by the type and stage of the infection.

People at Risk of Acquiring MRSA Infections

MRSA infections can occur in any geographic location and anywhere on a person’s body and can affect anyone. Historically, MRSA infections occurred in hospitalized patients, but now these infections are common in the community. The biggest risk factor for MRSA infection is open or broken skin (such as a wound or surgical site); however, MRSA infections can occur even on areas of the skin where there is no obvious wound or break in the skin.

Patients in Healthcare Settings

Patients in healthcare facilities have weakened immune systems and undergo procedures (such as surgery) or have catheters inserted into the skin that make it easier for MRSA to get into the body. It is for this reason that healthcare personnel must follow infection control procedures (such as hand hygiene and proper catheter care) to prevent patients from acquiring MRSA infections. When patients get MRSA in healthcare facilities, the infections tend to be severe. Common infections include surgical wound infections, urinary tract infections, bloodstream infections, and pneumonia.

Visitors of Infected Patients

When visiting MRSA patients, individuals should follow the facility’s visitor policies. Casual contact—such as kissing, hugging, and touching—is usually acceptable. Visitors should avoid touching catheters or wound sites and should wash their hands before leaving an infected person’s room.

I am hoping that some medical professional at the Hospital or the Ministry of Health would take a closer look at the increase in deaths at the PMH most especially for those who have been there for less than three days or a week.

We need to quickly enlighten staff and visitors alike of this bug and our hygiene practices at the Hospital. Persons from the community tend to be hostile towards staff when they are informed of the Ward rules but with much publicity of this “super bug” they may exercise different behavior.

Visitors should be made to wash their hands thoroughly before entering any ward to visit a patient or given hand sanitizer on entering the wards to help reduce the spread of the bug. Nursing staff and ward aids should at best always wash their hands before attending to the next patient. In Dominica we have this patois slang saying (tou pwase paka fais jous overt)”patois spelling may not be correct, but you get the idea – ” too busy doesn’t bring daylight quicker”.

There are numerous research sites on the internet to enlighten about this bug and persons should make it their business to know about this bug.

 

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49 Comments

  1. J
    May 1, 2013

    Observer, I agree with you 100%. Dominicans do not feel they deserve the best, they are groomed to beleive that the Government is doing them a favour. It is sad, but true, we expect crappy service and don’t feel we deserve otherwise. The writer was not criticizing the hospital, rather just pointing out that this virus/disease is something that should be investigated amongst the sick and dying.

  2. patriot
    May 22, 2012

    We dominicans are so good at criticising every thing we have and not doing anything to fix it… For those who say they have gone oversea and healthcare is so great … speak the truth. In most countries the public healthcare system is terrible. I agree that PMH is in dire need of resources but most of the workers do the best they can in these circumstances. I would like to suggest that instead of degrading PMH, maybe we should make a few donations to the place…

  3. OBSERVER
    May 21, 2012

    I have read quite a few comments of ‘you get what you pay for’ and ‘healthcare is free in Dominica so take what you get’. I beg to differ. No matter where you are, you deserve proper health care. Dominica may not have all the resources like America but that does not take away from basic healthcare. First, to be treated as a human being is a basic right and when you come to PMH or any of the health centers, health care professionals need to treat you with dignity and respect. Then, while giving you care, the basics of hand washing and standard protective personal equipment such as gloves and masks is necessary. Even if we do not have scanners and MRI machines, we can still prevent the spread of infections. For those of you who think healthcare in Dominica is free, we pay for it through taxes!! Social security contributions!! We deserve basic health care. (P.S. In the US, if you do not have health insurance, you will still get healthcare. You will get a huge, ridiculous bill after, but you will still get care)

  4. Shameless
    May 21, 2012

    Sometimes we try not to politicise everything but I guess Jerry Brisbane was 1000% right when he said we could spend the 25 Million being used for the state house on something more beneficial to the populace. Here we have a hospital and health care system in such dire straits yet we spending so lavishly on something that can wait.

    When oh when will we put our priorities in order? I guess the politicians dont care because the state will send them overseas for medical treat even if its only to remove small leasons on the knee that can actually be done in a health center.

    But, god is good all the time and he will see us through…soon!!!

  5. observer
    May 20, 2012

    There are various challenges in the healthcare arena. The one thing that is constant is continuous room for improvment. The article suggests that there may be a problem at PMH. I believe that the authorities should consider it and take steps to improve the quality of care at PMH. The challenge ofcourse is getting the neccessary equiptment and the many things needed to provide the upgraded care at the hospital. A suggestion would be to slicit concerned citizens and organization for funds to establish first class care at PMH

  6. CHARMER
    May 20, 2012

    There is a great need for hand sanitizers at the exit doors of the hospital if not of each wards. I was greatly disappointed once, when I went to a face basin close to the pharmacy to wash my hands, to find no liquid soap. There need to be an improvement in this area for sure. I hope the powers that be read this article and the comments.

    • Maria
      May 20, 2012

      The single most effective way of preventing MERSA transmission is good old hand washing – not hand sanitizers.

  7. Girlfriend
    May 20, 2012

    Thanks for this article. But I think there is something greatly wrong at that hospital, especially in the operating room. I’ve heard of some horrible things going on in there. DR’s walking in with dirty clothes like coming from a pig farm. Who knows what he is brining in. I wonder if he even washes his hands before he does surgery. I have a family member who suffered dearly from an infection from that hospital, and is still suffering. MRSA can also be carried in the urine, and also in the eyes. Universal Precaution is one of the utmost.That is if they know what that is at PHM

    • fly on the wall
      May 21, 2012

      Don’t be silly, obviously you dont know how a theater is organized…you walk in dressed however you wish, there is a preliminary room where you change your clothes and shoes into sterile ones, put on mask and hat. from there on you step into a mid sterile room where you SCRUB your hnds and arms up to past elbow with a SCRUBBING BRUSH and industrial strength soap. You then enter the sterile room where you are draped with more sterile clothing..this time a gown, that is long sleeved and full length over your body, and you put on sterile gloves. The patient is also cleaned with iodine and draped with sterile covers..and then the surgery begins. No one who is not prepped in this manner takes part in the surgery. MRSA occurs in ANY hospital in the world…lets not blame our doctors and nurses but search for a solution!

  8. May 20, 2012

    THIS LETTER FOLLOWS A NOTE THAT I WROTE ON DNO MANY MONTHS AGO….I CAME FROM ABROAD WITH MY SON WHO FELL SICK ON THE WAY TO DOMINICA,THEY DAY I TOOK HIM TO THE HOSPITAL HE WAS ATTENDED IMMEDIATELY ALTHOUGH THERE WERE MANY PEOPLE IN THE QUEUE …HE WAS CALLED IN BEFORE THEM BECAUSE HE HAD A SERIOUS BREATHING PROBLEM …FIRSTLY WHEN I ENTERED THE EMERGENCY UNIT THE NURSE WHO WAS IN CHARGE AT THE MOMENT HAD A WOUNDED FINGER IN A PLASTER WITH THE BLOOD SHOWING ;NORMALLY THAT NURSE SHOW HAVE GLOVES ON,,,SECOND ERROR I NOTED ANOTHER LADY WAS LAYING DOWN ON A LITTLE BED WITHOUT A SHEET OR DISPOSABLE PAPER ON ,THIRDLY THE LITTLE PLASTIC WHICH IS APPLIED TO THE THERMOMETER TO TAKE THE TEMPERATURE WAS WASHED IN A PLASTIC BREEZE PAIL IN A SINK WHICH IS IN THE SAME AREA WHERE PEOPLE ARE TAKEN IN THE EMERGENCY ROOM …LAST ;THE TOILET WAS VERY SMELLY IN THAT SAME ROOM .. TO MAKE A LONG STORY SHORT ,ALL THIS IS ABNORMAL…

    • Shameless
      May 21, 2012

      Thanks for this information. You are always a valued contributor. However, if Admin afraid to tell you, I will. UNLOCK those CAPS because you are hurting my eys and making it very hard to read.

      Thanks!

  9. Let's be real!
    May 20, 2012

    Let’s be real. Ho many of us will be willing to pay the true cost of health services from PMH so to buy and maintain the needed CT and other needed equipment? We want free health care but demand 1st class service! If we pay and pay the true cost,we can get the 1st class health care from PMH as there is alot of talented staff and other well trained Dominicans.

    • Mizz J
      May 21, 2012

      ummmm…thats rubbish.
      Whether persons want to pay or not, the hospital is there to serve a purpose and at its worst, people shouldnt get sick from visiting the hospital. Free health care doesnt apply there at all.
      We need to demand better from the persons who are there to provide better. We are too comfortable settling for less and that’s our problem.
      Our population is 69,000 and if something major is to happen, we’ll all be dead.
      If we claim to have a hospital, we should have a hospital.

    • En Ba La
      May 21, 2012

      @Let’s be real! so according to what I am reading you are telling me we should continue to use BREEZE BUCKETS AND BLEACH. I had to go buy my own antibiotics to take to the hospital to treat my child while he was at the hospital – I did pay. Now the scan is not free – One has to pay – is it $500 – a few years back that was the cost they asked for my dad’s.

  10. Aye Dominique
    May 20, 2012

    Interesting interesting interesting…..this has been playing on my mind also for some time and I must say thanks to the writer for bringing this out.

    This is quite significant, and controlling bacterial infection in the hospital setting is key. It’s not just washing of hands, it goes alot further, care of medical equipment, especially those that has to be reused, how we treat patients in isolation and how we dispose of or clean items that have been used by them, how we clean after patients. I have witnessed beds being turned over and trust me, one patient leaves, its just a fast wipe up, bed turn and sheet on it.

    Health care workers have to understand their surrounding and the level of risk involved.

    I hope this article gives authorities something to think about

  11. Anonymous
    May 20, 2012

    Maybe we should have statistics on how many surgery we have that do NOT die. The thing is the deaths are the ones profiled and it is difficult to make any conclusion with one side of the story.

    Because we hear thunder after we see lightening does not mean that lightening causes thunder.

    • Mizz J
      May 21, 2012

      You’re obviously a health care practitioner. Note: people are not supposed to die at surgery-they do at times, yes. But you cannot tell us to observe “how many surgery we have that do NOT die.”
      Is that any way to measure success? By those who do not die? Ridiculous.

  12. POSITIVELY DOMINICAN
    May 20, 2012

    THIS IS AN EXTREMELY SERIOUS STATE OF AFFAIRS AND NEEDS TO BE ADDRESSED WITH UTMOST URGENCY!!!!

    MRSA is an extremely fatal pathogen (patients could be colonised or have MRSA sepsis). A patient who is extremely sick, immunocompromised patients, patients who have had surgery, and patients with open wounds can succumb quickly to MRSA infection, which could lead to death. A patient could habour MRSA for months (hospital and community.

    All colonised patients or patients who have been diagnosed with MRSA MUST be cohorted and strict infection prevention and control practices MUST be adhered to. Scrupulous hand hygiene is paramount!!
    Nasal and groin swabs MUST be taken for all patients. All patients MUST be decontaminated with Chlorohexidine 4% baths for 7 days and bactroban (cream) nasal instillation for 5 days. Health professionals,Vistors family members MUST adhere to strict hand washing practices.

    The following needs to be considered:

    Are there breeches in infection prevention and control practices?

    Are instruments/equipment properly decontaminated after patient use/between patient?

    Are procedures to open wound done aseptically?

    Are invasive procedures carried out aseptically?

    Are surgical intruments decontaminated scrupulously, and packaged aseptically?

    Are all health professionals decontaminating (washing and alcohol gel) their hands between patient contact?

    Are visitors decontaminating their hands before they enter the wards and after their visit family/friends?

    It is time to step up infection prevention and control practices at PMH!!!!

    I was appalled by the poor hand hygiene practices amongst visitors, and especially health professionals when I visited a family member who was on the male medical ward last year. Furthermore, the ward was extremely cluttered, with patients in the centre of the ward due to influx of patients and decreased bed capacity. This practice certainly increases the risk of cross infection.

    The newly appointed Matron, The Hospital Administrator, The Infection Control Nurse MUST ensure that infection prevention and control practices are adhered to in every ward/unit.

    Having a link infection control nurse on each ward who can ensure that infection prevention/control standards are maintained is essential. This link nurse could report to the Infection Control Lead Nurse any infection prevention/control issues.

    Auditing could be carried out to ensure infection prevention/control standards are maintained. Example, hand hygiene audit (weekly) and report findings to staff (medical/ nursing/auxilary) anf other appropriate personnel.

    The Infection Control Nurse MUST visit every area to observe infection prevention and control practices.

    Health professionals MUST be bare below the elbows execept for wedding band (ring)

    Ties should not be worn by doctors in the clinical area or when having direct contact with patients, because this has a tendency of dangling over the patient or the patient bed linen.

    There are 5 moments for hand hygiene:
    1. Before patient contact – to protect the patient from microorganisms picked up from other patients or the general healthcare environment.

    2. Before a clean or aseptic procedure – to protect those sites from contamination with microorganisms derived from the patients own flora or the general healthcare environment.

    3. After body fluid exposure risk – hands will be contaminated by contact with blood or body fluid.

    4. After patient contact – to avoid transmitting microorganisms from the patient to the general healthcare environment or other patients.

    5. After contact with patient surroundings – these may be contaminated with microorganisms derived from the patient.

    IF GLOVES ARE WORN FOR THE ABOVE, THESE MUST BE REMOVED AND HANDS CLEANED AT THE INDICATED TIMES STATED ABOVE.

    Alcohol gel MUST also be placed at each bedside to be used.

    Poor infection prevention and control practices put patients lives at risk and increases morbidity (hospital acquired infection) and mortality. It also increases the patient’s length of hospital stay and therefore,puts a strain on limited resources.

    INFECTION PREVENTION AND CONTROL IS EVERYBODY’S BUSINESS. THEREFORE POOR PRACTISE NEEDS TO BE CHALLENGED!!!

  13. May 20, 2012

    I do not know anything about medicine and the reasons it is treated to people who are sick–I only have diabetes and hypertension–which is now under control through medication, of course; so I have nothing to say for or against this “Super Bug” observation.

    I can only say that those people, who have died recently, at the PMH, were people of age. They had been sick for a while, and our days in this world were numbered, long before we were conceived in our mothers womb–who can stop the day on which they will breath the last breath?

    The other thing is that, those who have died at the hospital, are almost less than a few, even if the deaths occurred kind of close to the other. That too is not strange! For example there can be an abnormal number of people murdered in one month and in the next month there was none.

    I am not suggesting that we simply sit and wait for the day we will pass away in the body–I am a person who speaks for good healf and Life in me–day in and day out, by my faith in the blood of Jesus Christ. It just seemed to me that it is too soon for to claim “Super Bug” whatever that is, as the reason for deaths at our hospital–sometimes those kinds of alarm simply make matters worst for everyone.

    We need to have some form of peace of mind at least once in a while, if we are going to survive this turmoil of existence in this world.

    God is our greatest protector, Doctor or Nurse–His Love is the greatest oinment of healing, for both our physical and spiritual bodies. There is no extremity of human wisdom and philosophy which can alter or change what God has planned or established in the lives of those who believe and put their trust in Him.

    A hospital, whichever it is and wherever it is, is for sick people in the first place. For many of us it will be the last place we will exist during our days on this earth. It is a place where many people will die–regardless of their sickness or health condition when they are admitted there.

    Can we human beings try to ease off on tying to solve everything by our own strength–what is known as human wisdom and philosophy? I has not been effective and it never will–because God will always be in control.

    After all, what good is this alarm about “Super Bug” to my mind, if I am admitted to the PMH as a sick person, and especially a person of age. That feeding will simply provoke my mind to surrender to death–that is the point I am making.

    I don’t care about the thumbs down either! I just cannot deal with so much negativity all of the time–it is bad for us, both spiritually and physically.

    • thinker
      May 20, 2012

      There is a young patient right now in her early twenties who almost died last week, after having surgery the week before and being discharged, just two(2) days after she had major surgery. She had to be rushed back to surgery a week later, and ended up on a ventilator in ICU. This is a young person in the prime of her life, with no significant medical history.
      There seems to be a problem at PMH, and until we stop making excuses and adressing the issue at hand, we will not get anywhere with this situation. Is that the state of affairs in the medical dept. We are worried about the number of young men smoking Cannabis, but patients are checking into PMH, and many of them are checking out dead. Who is looking at the standards of practice?

      • Maria
        May 20, 2012

        Hey people let’s not get carried away with exotic ideas. There is a health problem called Pulmonary embolism which may be a complication occurring after surgery and is beyond any health professional’s control. So let’s stop demoralizing our health professionals for reasons unknown. It is OK to contribute to a conversation, it is even better to investigate before we comment on matters such as these and throw the whole community into a panic with unfounded suggestions.

  14. wiser than
    May 20, 2012

    taht’s some real troubling information. because we in dominica yes we i too take things way to serious.this needs to be looked into very urgently.

  15. Ambassador A
    May 19, 2012

    While I am very happy that this information is being transmitted to our people, I must step in to clear some misconceptions that this article may incur. MRSA is exactly what the article says but MRSA infection does not kill anyone within one or two days of surgery. We all have staph on our bodies. The resistant staph is something different but because it is staph, the body is already used too the presence of this bacteria. The problem occurs when it infects an open wound on the body. Then it is difficult to eliminate because it is resistant to the drugs. As a healthcare professional, I see patients everyday who have MRSA. They live for years with MRSA infections. We do have to put them on contact isolation to prevent the spread of the bug as it cannot be cured. I think that PMH needs better internal screening in terms of ct scans and ultra sounds to determine what is going on inside the patient. Post surgical patients tend to bleed internally and also tend to develop fatal blood clots. There is a lot more that could be said but we do not profess to know it all.

    • @WELL
      May 21, 2012

      If you read the article carefully and done a bit more research for yourself you would have noted that persons in healthcare settings especially just after surgery their immune system is weak and sometimes incapable of fighting back the bacteria which could encourage death; also if the medication prescribed or antibiotics couldn’t act quick enough. Enlighten your mind. I have worked in an environment where I personally witness this kind of thing and it’s not pleasant.

      • Ambassador A
        May 21, 2012

        If you are looking for an avenue to increase the size of your head, this is the wrong one. I do work at a healthcare facility, I have personally witnessed MRSA infections and it is from this I can tell you that MRSA infections do not kill anyone within two days!! It may eventually lead to their demise but not in two days after surgery. The main culprits of death after surgery are pulmonary embolism and internal bleeding. Infections are a process. It takes time to develop. Some are more aggessive than others but it has to take time. If you did some research for yourself, you would know that surgery does not weaken your immune system. It is just a huge portal of entry for organisms to infect you i.e a direct entry point carried quickly by the blood. Also, for scheduled surgery, the patient is given antibiotics prior to the surgery to help fight any infections which may occur. For future, try not to insult other people’s intelligence!!!

  16. En Ba La
    May 19, 2012

    I would want to think even before this concerned citizen wrote this letter to DNO that investigation would already have been launched. I would want to think also that two th leading to death ree complications following surgery would be investigated furthermore it is not one.

    At least I hope they take note and check. It might not be MRSA but sterilization techniques or something else. I hope they hear the concern and act and release something NOT just reassurance TALK but show something is being done.

    • En Ba La
      May 19, 2012

      Thanks for info Concerned citizen and writing as lots of us may be concerned but not enough to go this mile which is more important than just saying it to self

  17. Dominican
    May 19, 2012

    This is cause for great concern! I hope the problem is taken care of quickly!

  18. Met Veye'
    May 19, 2012

    Well written article. Such articles are surely worthwhile to read.

    This MRSA have been at the hospital for a while. Just look at the number of infections patients get there especially after surgery. If such infection is not treated quickly, and with the CORRECT antibiotics, death can result. Two years ago, I had a first-hand experience dealing with a family member got infected with MRSA, who spent over a month at the PMH. Hats of to the doctor who treated my family member.

  19. hahahha
    May 19, 2012

    The authorities knows about the bacteria in the operating room. Persons were infected after operation, some seek further attention overseas and other at the private hospital on the island. Address the problem before more persons dies.

  20. lisad
    May 19, 2012

    This is why Research should be an integral part of any hospital so that nursing and medical practices can be evidence based.

  21. Woodford Hill girl
    May 19, 2012

    Well presented,lets hope the health dept hearkens because this infection starts primarily in health care facilities,and if I might add that cleaning the room and furnishings of an infected patient after discharge need special attention!

  22. Anonymous
    May 19, 2012

    Very good informative article. It would be beneficial if he health personnel speak with you to help the hospital.

  23. Sensey
    May 19, 2012

    I also think they should do something about the rubbish at the back of the hospital. That’s an awful sight to behold.

  24. Sharon
    May 19, 2012

    I work in a hospital where we get MRSA patients and before we enter the room we have have our protective clothing, which would include gown, mask, and gloves. The patient is also in isolation and the room door has to have the necessary precaution labels. Anything thing that is in the patient room has to be bagged properly. Not even the ice jug is taken from the room, one is left outside and it is taken and filled up to fill the one in the room.

  25. IMpatriotic2
    May 19, 2012

    Healthcare workers (sorry) are the usual culprits of the spread of hospital acquired(Nosocomial) infections. Observing Universal Precautions, that is you treat all patients as potential carriers of all kinds of disesses, therefore you wash you hands between patients,before and after care and also wear gloves wash hands and change gloves between patients. Encourage the patients to wash their hands frequently and use an alcohol based sanitizer or a 1:10 bleach solution for sanitizing furniture, linen, utensils, thermometers etc. Medication & disease prevention teaching, infection prevention should be taught throughout the country at all levels. Starting in Kindergarten – frequent thorough handwashing, teaching how to sneeze and cough into the crook of your elbow elbow away from others. Use disposable tissues and dispose of properly. Patients are also not to expect antibiotics for the slightest ailment and when prescribed an antibiotic make sure that you COMPLETE the prescription. If you stop taking the antibiotics before completion, you may cause resistance to your immune system and the next time that you need treatment they may not work for you. Health Maintenance/ Disesse Prevention Education is the key.

  26. shy
    May 19, 2012

    Thanks, this is very good information.

  27. j
    May 19, 2012

    the ministers all seek medical attention overseas anyway,they don’t care

  28. May 19, 2012

    This will also shed some light on Super Bugs
    A handful of cases of NDM-1 — New Delhi metallo-beta-lactamase — have been reported in B.C., Alberta, Ontario and Quebec in people who picked up the infection while in hospitals in India or in Pakistan.
    Photograph by: AFP , Getty Images

    A drug-resistant superbug that’s spreading globally has been found in two Toronto-area people — a woman who went abroad for a controversial MS treatment and a man who hadn’t travelled outside Ontario in more than a decade.

    The latter case is believed to be the first time the organism, dubbed NDM-1, has been contracted in Canada — a finding a leading infectious disease expert called “alarming.”

    A handful of cases of NDM-1 — New Delhi metallo-beta-lactamase — has been reported in B.C., Alberta, Ontario and Quebec in people who picked up the infection while in hospitals in India or in Pakistan.

    The NDM-1 gene enables bacteria to be resistant to “big gun” penicillin-type drugs called carbapenems, says Dr. Susan Poutanen, a medical microbiologist and infectious disease physician at Mount Sinai Hospital in Toronto.

    The gene sits on a plasmid — a tiny chunk of DNA — and can move from one bacterial species to another. “This plasmid often also carries resistant genes to other classes of drugs,” Poutanen says — meaning that, if people get sick with NDM-1 producing bacteria causing significant infections, there are only one or two drugs, at best, to treat it.

    The gene can jump into common bacteria, including E. coli, that can cause a spectrum of infections — including hospital-acquired pneumonias and urinary tract infections that, in serious cases, can lead to septic shock and even death. The strains that harbour the gene tend to be multi-drug resistant, meaning doctors could be faced with a severe pneumonia, with virtually no remedy to administer to patients.

    “I think it’s pretty alarming,” said Dr. Gerry Wright, scientific director of the Michael G. DeGroote Institute for Infectious Disease Research at McMaster University in Hamilton. If NDM-1 is spreading between people in Canada, it would mean “more death and more disease and more hospital stays, and more extended challenges for the clinical community.”

    There’s no way of knowing right now whether that’s happening, he said. But the report “raises a pretty significant red flag that we need to be looking for it,” Wright said. “Is this just a one-off, or is this the harbinger of things to come?”

    In hospitals, it can spread between patients via the hands of health-care workers or contaminated equipment, according to the Public Health Agency of Canada. Now endemic throughout India and Pakistan, NDM-1 is spreading worldwide because of travel, medical tourism and its ability to move stealthily between bacteria, Poutanen’s team wrote in the Canadian Medical Association Journal.

    The report describes the case of an 86-year-old man admitted to a Toronto hospital and rehab centre for a stroke: he later tested positive for NDM-1. He hadn’t travelled outside of southwestern Ontario for the past 10 years; none of his family members or friends had travelled to India or to any known endemic regions. All the patients on the ward he had been admitted to were swabbed. No one had any NDM-1-producing organisms.

  29. doznmatta
    May 19, 2012

    Very informative and interesting article.

    Whether or not this “bug” is doing mischief in Dominica and at the PMH, it is a community health concern that should be addressed if that is not already being done. If it is being addressed, then perhaps it should be given greater attention, if only to put the community’s fears at bay.

    Even without such fears people spend so much money to go overseas for health care and many come back dead anyway or die shortly thereafter. So going overseas may not even be the answer. Let us take care of our own situation as best as we can for everybody’s sake.

    • Anonymous
      May 19, 2012

      Most if not all of the times, people go overseas not because of lack of confidence in the local system but simply because of lack of technology and equipments needed to diagnose and treat certain conditions. A lot of lives could have been saved if our hospital was up to date with equipments and more specialist. most of the surgeries people undergo to treat conditions can be avoided if the hospital was equip with the technology to diagnose the condition. sometimes the doctors are simply experimenting on patients hoping that what they assum is the problem is in fact that. People lives are more important and I think the government and healthcare providers need to invest more in upgrading our healthcare system. It is too much about making money from patients instead of focusing on getting them better.

    • Anonymous
      May 20, 2012

      well said, and to the point

  30. May 19, 2012

    MR. DON CHRISTOPHER AND LOFTUS EMANUEL WERE BORN IN NEW TOWN AND THEY BOTH DEPARTED AROUND THE SAME TIME,I REST MY CASE.

  31. Shameless
    May 19, 2012

    Hmmmm. Very interesting article. Could it be the culprit lurking to strike again. Now is action time,

  32. Anonymous
    May 19, 2012

    Health inspector!

    • I wonder!!!
      May 19, 2012

      Health inspector is joke!! Scientist would be a better term!!!

      So all you want them to publish the cause of death of patients now?

      Because you all don’t know the cause of death, you all wanna put it on “superbug”!! tsk tsk tsk

  33. 4u2C
    May 19, 2012

    I ssupected tha quite a while now and spoke to some concern Dominicans about that bacteria but I guess am Mr. Nobody and it not there mother, siter, father, brother or child dieing so the authorities DON’T CARES!!

    • Anonymous
      May 19, 2012

      Then why don’t you reveal your true identity

      • Girlfriend
        May 20, 2012

        You’re not reveillg your so why should the other person?

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