The Public Health Agency of Canada is warning hospitals across the country to be on the lookout for a highly drug-resistant "superbug" that could be brought back by wounded soldiers from Afghanistan and could contaminate hospitals here.
The bug is called Acinetobacter baumannii and is a strain of a fairly common bacterium, acinetobacter.
"It's a germ that is found worldwide, usually in the environment -- the soil, dust, water -- things like that," Dr. Andrew Simor at Sunnybrook Health Sciences Centre in Toronto told Canada AM Thursday.
But this strain has grown particularly virulent, resists numerous antibiotics, and can cause pneumonia, respiratory failure and other complications.
The strain was first identified after it started infecting U.S. soldiers returning from the war in Iraq. It has been called a potentially "major threat to public health" because of its ability to mutate rapidly and develop a resistance to many classes of antibiotics.
At least nine Canadian soldiers who had been serving in Kandahar have developed pneumonia from the strain after being transferred back to Canada for treatment.
A study published in August documents the cases of four injured Canadian soldiers who developed A. baumannii pneumonia that was resistant to antibiotics. The source of the infection turned out to be the Role 3 Multinational Medical Unit field hospital in Kandahar.
So far, it doesn't appear that any Canadian soldiers have died of an A. baumannii infection. Nor have any infected soldiers who were transferred back to Canada passed the bug on to civilian patients in Canadian hospitals.
But infectious disease specialists say the worry that it could happen is very real.
"The concern is that these soldiers, once they have been medically stabilized overseas come here to Canadian hospitals where they require further surgery. And if they carry these treatment-resistant bugs, there is the potential for the organism to spread to other hospitalized patients," Simor says.
Outbreaks that may have originated in soldiers coming from Iraq or Afghanistan have already occurred in U.S. and British hospitals.
That's why the Public Health Agency of Canada has put hospitals on alert, and is planning a national meeting on infection control measures for January.
"We're fortunate in Canada because we've been forewarned or alerted to this possibility and so the soldiers who have come back with this organism have not been a source of spread," says Simor.
"We screen them on their admission to look for this resistant organism, then we isolate patients if they are carrying the organism."
The bacterium is not seen as much of a danger to healthy people outside of hospitals, but it can lead to serious infections in some.
"People who are already critically injured, they can develop serious infections from this bug," says Major Dr. Homer Tien, a surgeon at Kandahar Airfield hospital.
"If they develop this kind of infection, they stay longer in the intensive care unit. And certainly the longer you stay in the intensive care unit, you're more prone to developing other complications."
With worries that some of the infections at the Kandahar hospital may have been caused by ventilator equipment that wasn't fully cleaned, doctors have tightened their infection control measures at the medical unit.
"Certainly, washing your hands is probably the biggest thing you can do to prevent these sorts of infections," says Tien. "And certainly that's been a big part of the infection control practice at the Role 3 hospital in Kandahar where we now have fairly stringent hand washing guidelines."
Doctors say it may not be the most pressing threat to public health, given that there are so many other more superbugs that hospitals are contending with, most notably MRSA.
"Nonetheless," says Simor, "we have to take it very seriously because it is so resistant to so many antibiotics. Also, there may come a time when we lose the ability to treat these infections because they become so resistant.
"Canadian health care providers need to be aware of this and know that soldiers may be carrying these resistant germs on them."
With a report by CTV medical specialist Avis Favaro and producer Elizabeth St. Philip
