A deadly superbug that has ravaged Europe and North America has arrived in Australia, but experts fear it is being missed because of inadequate testing.
Up to 40 per cent of serious cases of Clostridium difficile, or C diff, are possibly being missed in NSW, researchers have found. The bug often causes severe gut problems.
Specialised labs are finding highly toxic superbug strains of the bacteria more often but the extent of the problem is unknown because the strains are not the subject of routine testing.
In May, Victoria's Chief Health Officer Rosemary Lester revealed that 14 Victorians had died from C diff after picking it up in hospitals and aged care facilities over a 15-month period in 2010 and 2011.
Thomas Riley, a professor of Microbiology at The University of Western Australia and an expert in C Diff, said his lab had seen a dramatic increase in a superbug strain known as 244 towards the end of last year.
He believed there was a “massive under-reporting” of the bug, and health departments around the country had been too slow to respond.
“I'm really scared about this. I think we are heading for a very dark time, I'm afraid,” he said.
In the past 12 to 18 months, the 244 strain had gone from being non-existent in Australia to being the third most common strain, accounting for five per cent of tested cases.
He said routine testing of C diff strains was urgently needed.
Part of the problem was that while infectious bacteria was commonly spread among patients in hospital, C diff seemed to be spreading throughout the community and it was not known why.
“There is a lot of nasty C diff in the community, it is severe disease,” he said.
He suspected imported food could be responsible for spreading the bug.
Superbug strains of C diff are more widespread in North America and Europe.
Between six and 30 per cent of patients die from the disease and deadly cases are becoming more common, according to data published by the US Centres for Disease Control and Prevention.
The director of the Centre for Infectious Diseases and Microbiology, Lyn Gilbert, said monitoring varied between health districts. Testing did not always look for superbug strains, but there appeared to be an increase in the disease that was likely linked to the 244 strain.
“It has appeared really from nowhere sometime last year and it's been seen in all the Australian states, and I gather in New Zealand as well,” she said. “The problem with 244 is it has a number of characteristics in common with the nasty strain that spread all through the northern hemisphere in 2005."
The spread through the community increased the likelihood that the bugs were being picked up through food. Unnecessary use of antibiotics was driving the spread by weakening people's natural defences to the bug because antibiotics wipe out natural gut flora.
An audit of patients in the Northern NSW Local Health District has indicated up to 40 per cent of cases of C diff are possibly being missed.
Many patients with severe diarrhoea were not tested for the bug. While 60 cases were identified in the district over 18 months, the actual number of cases was more likely to have been closer to 100, according to research presented at the Australasian College for Infection Prevention and Control Conference last week.
About half of the cases appeared to have been spread through the community, while the rest were picked up in hospital, the research found.