Drug-resistant gonorrhea emerges from "antibiotic soup"
In just four years from 2002 to 2006, the proportion of gonorrhea cases in Canada that were resistant to the class of antibiotics known as quinolones rose by a factor of seven, from 4% to 28%. The rise in quinolone resistance has outpaced even the significant increase in the number of gonorrhea cases detected in Canada over the past ten years.
The new data were reported in this week's issue of the Canadian Medical Association Journal by a team of researchers from Toronto, Ottawa and Winnipeg. [CMAJ study]
Quinolone resistance was much more common in patients older than 30 than in younger patients, and more common in men than in women, the researchers reported.
The authors of the study urged doctors to abandon quinolone as therapy for gonorrhea patients, for whom it continues to be prescribed "perhaps because of the convenience, safety and tolerability of quinolones."
In an accompanying commentary [CMAJ commentary], Dr John Tapsall, an Australian microbiology researcher affiliated with the WHO Collaborating Centre for Sexually Transmitted Diseases, wrote:
"Individual practitioners can make an important contribution to solving the problem. Appropriate use of antibiotics in general is fundamental to the control of drug resistance in all community-acquired pathogens. Familiarity with and adherence to recommended treatment regimens for gonorrhea is also crucial.Lead researcher Dr Susan Richardson told CBC News, "Really there needs to be a Canada-wide surveillance project that is probably ongoing into the future to keep tabs on what's happening to resistance for this important public health pathogen." [CBC News]
"[...] the gonococcus exists in an "antibiotic soup" resulting from general misuse of antibiotics, which subjects the organism to substantial evolutionary pressures. Until these crucial areas are addressed more effectively, all countries will be at risk from the emergence and spread of even more resistant variants of this highly adaptable pathogen."
Dr Tom Wong, the Public Health Agency of Canada's director of community-acquired infections, said a national surveillance system is in the works. "We are very hopeful that very soon we will have some of the pilot sites up and running. But at this time we are still actually trying to get all of those logistics set up." [Canadian Press]
Transmission prevention, of course, remains a priority as well. (Hence the great stock photo above.)
Clear the hallways
New Brunswick's chief fire inspector said he often has to remind hospitals not to put patients in the hallways, as the practice violates the province's fire code. [CBC News]
That may sound all well and good, but someone should remind the good inspector about an incident at the Saint John Regional Hospital a year ago when an 86-year-old patient was placed in a shower room overnight because there was no bed for him. [CBC News] If not the hallways, then where will the overflow patients go?
"State your emergency"
The Canadian government telecom regulator will require all cell phone companies to enable their phones to be traced to their location by emergency responders. The change, which comes in response to several highly publicized deaths in cases where callers could not be found quickly, must be made by next year. [Globe and Mail]
IHI comes to Canada
The Institute for Healthcare Improvement's 10th Annuaal International Summit on Redesigning the Clinical Office Practice will be held in Vancouver from March 22 to 24. A $100 early registration discount applies if you register before Saturday. The full price is $895 USD. [IHI]
Radiological imaging blog Not Totally Rad hosts this week's edition of Grand Rounds, the collection of the best writing from the health blogs. [Not Totally Rad]
Family resemblance? Not so much
Ontario Health Minister David Caplan's brother, Zane Caplansky, who was also a politician for a time, has abandoned the public service, changed his name back to its original form, and become a smoked meat sandwich vendor in Toronto. That may not be quite as healthy a contribution to the public as his brother's cabinet position, but it's sure hard to condemn a good smoked meat sandwich. [National Post]