What's The Risk Of Catching A Super Bug In Singapore?
Generally, if you are warded in a hospital here, you already have a one in nine chance of catching a bug during your stay. Last October, ST reported that a comprehensive study of 5,415 adult patients in 13 acute hospitals here found that 11.9 per cent caught an infection while being treated for other conditions.
Patients in every single bed in eight public and five private hospitals were involved, including those in intensive care. Together they accounted for more than 86 per cent of acute care beds in the country in 2014
But the risk of healthcare-associated infection (HAI) is not equally spread. Those staying in public hospitals have a higher risk of catching a superbug.
In the study commissioned by the Ministry of Health, slightly above 12 per cent of patients staying in public hospitals compared to less than nine per cent of private hospital patients were affected.
The paper also noted that the 11.9 per cent HAI rate here is higher than the six per cent in Europe and about nine per cent in other South-east Asian countries. But the higher rate here might be due to a different mix of patients.
Photo: The Straits Times
Who's Most At Risk Of Catching A Super Bug?
Men, older people and surgery patients are among those most at risk. Older men in hospital for surgery were identified as the group at highest risk of getting an infection during their stay. Singapore has an ageing population and older people tend to have multiple illnesses that reduce their resistance to bugs.
In general, surgery patients have 1.8 times the risk of other patients, and men had a 1.5 times higher risk of infection than women.
How Do Infections Happen?
Some bugs causing infections could have been brought in by the patient, laying dormant until the person’s immune system was breached. A common reason for a breach is the use of catheters, says Associate Professor Hsu Li Yang, who heads the Infectious Diseases Programme at the NUS Saw Swee Hock School of Public Health.
The study found that half of urinary tract infections, a quarter of hospital-acquired pneumonia and a fifth of bloodstream infections were linked to the use of such devices.
This is because such devices allow the bug to bypass the body’s usual protections, Prof Hsu said. The MOH study noted that infections contracted these way were “highly preventable”.
Why Are Super Bugs So Deadly?
Newer, more evolved super bugs are more resistance to antibiotics, antifungal and antiviral medication, making them more dangerous than ever. Candida auris is part of a much larger and growing global problem of antimicrobial resistance. The drugs could build up resistance in waterborne bugs and even fish – which could affect people who eat them.
Scientists say unless more effective new medicines are developed and unnecessary use of antimicrobial drugs is sharply curbed, risk will spread to healthier populations, reports The New York Times.
According to the UK Review on Antimicrobial Resistance, superbugs kill around 700,000 people worldwide each year. By 2050, 10 million people could die each year if existing antibiotics continue to lose their effectiveness, eclipsing the eight million expected to die that year from cancer.
The problem is so serious that the United Nations General Assembly was convened in 2016 to manage the crisis of increasing resistance to antimicrobial drugs.
More than half the patients in Singapore hospitals are on at least one antimicrobial, and not all patients on antimicrobials had infections; some received the drug as a precaution against infection.
Besides Candida Auris, What Kind Of Super Bugs Are There?
The study commissioned by the Health Ministry found that while most of the infections were mild to moderate, there were some that could be severe, possibly even fatal, and came on top of whatever medical problems patients were already being treated for. About one in four of those affected had an infection in their bloodstream, while a similar number had pneumonia.
Apart from general bugs, the most common “super bug” caught here was MRSA (methicillin-resistant Staphylococcus aureus). It’s so common it can stay on food without being destroyed by heat. In very serious cases, it could cause infections that lead to death. But the incidence rate for MRSA has fallen from 0.84 per 10,000 patient days in 2013 to 0.38 in 2017, MOH said in 2017.
Other hard-to-treat, multidrug-resistant bacteria include Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. These superbugs can cause infections that lead to septic shock and multiple organ failure.