Australia in the Grip of New Superbug

A new superbug that can cause potentially fatal colon infections has been detected in Australia, according to an editorial in the latest Medical Journal of Australia.

The first case of an epidemic strain of Clostridium difficile (C. difficile) thought to have been acquired in Australia has been identified at a hospital in Melbourne, and further clusters have been reported in residential aged care facilities, Dr Rhonda Stuart of the Monash Medical Centre's Department of Infectious Diseases said.

C. difficile infection can cause conditions ranging from mild diarrhoea to pseudomembranous colitis to toxic megacolon, and can be fatal. It is the most common cause of hospital-acquired diarrhoea, and now rivals methicillin-resistant Staphylococcus aureus (MSRA) as the most common health care-associated infection in the United States.

Since 2000, C. difficile infection rates associated with an epidemic strain (C. difficile ribotype 027) have increased in health care facilities in the US, Canada and Europe. This strain has an increased resistance to antibiotics, increased production of toxins and spores, and causes more morbidity and mortality.

"Australia is now also in the grip of this new strain of C. difficile," Dr Stuart said.

"It is sobering to contemplate that what has occurred in the US, Canada and Europe is potentially and imminently on our doorstep."

"We must learn from the experience of experts in these countries so that Australia can avoid a similar experience - we already have the benefit of their hindsight to guide us."

In a related article, the Australasian Society for Infectious Diseases has published its guidelines for the diagnosis and treatment of C. difficile.

They include stool tests for anyone who develops diarrhoea after a course of antibiotics or while in hospital, and treating patients with metronidazole in mild to moderate cases and vancomycin in more severe or recurrent cases.

The most serious cases may require surgery, Associate Professor Dr Allen Cheng of Monash University's Department of Epidemiology and Preventive Medicine said.

The Medical Journal of Australia is a publication of the Australian Medical Association.

Source: MJA