TORONTO - Antibiotic resistant Staph bacteria cost an estimated 2,300 Canadians their lives in 2006 and added a whopping $200 million to $250 million to the country's health-care bill, figures extrapolated from newly released national detection rates suggest.

They also suggest Canadian hospitals saw 29,000 new patients carrying methicillin-resistant Staphylococcus aureus bacteria in 2006, of whom 11,700 had new MRSA infections. (The remainder would have been carrying the bacteria on their skin or in their nostrils.)

Those figures were calculated based on detection rates for MRSA gathered through a national surveillance program which drew data from 48 hospitals. Because of the mix of health-care institutions in the surveillance program, the data are thought to reflect the situation in Canadian hospitals in general.

Dr. Andrew Simor, a Toronto infectious diseases expert who co-chairs the surveillance program, calculated the extrapolations.

The 2006 figures show a slow and steady increase over previous years, he said of the data, contained in a report issued Thursday by the Public Health Agency of Canada.

"I think it's a mixed story. There's good news and there's bad news," said Simor, chief microbiologist at Toronto's Sunnybrook Health Sciences Centre.

"The good news is our rates remain substantially less than what is seen in the United States and many other parts of the world. No question about that - that's good news."

"The bad news is despite our best efforts we've not yet been able to control the spread of MRSA in our hospitals and there is a continued and steady increase that has taken place, albeit at a slower rate than is seen south of the border. Nonetheless, this is of concern."

The director general of the Public Health Agency's centre for communicable diseases and infection control said more needs to be done to battle MRSA, which is the most common and most important, from a disease and cost point of view, of the antibiotic resistant organisms that plague Canadian hospitals.

"It just speaks to the fact that antimicrobial resistance is just a reality in today's world," said Dr. Howard Njoo.

"And it's something we need to address. Because it's not just a hospital or health care-based issue or problem. It's something in the wider community."

The report reveals the hospitals in the surveillance network detected 5,787 new MRSA cases in 2006, 62 per cent of which were thought to have been acquired in network hospitals. Fifteen per cent were believed to have been so-called community acquired MRSA. The remainder would have been acquired in long-term care facilities, hospitals outside the network or were of unknown origin.

The rate of community acquired MRSA has virtually doubled in this country in the last five years, Simor said. The main strain of the bacteria found to be spreading in non-hospital settings often causes hard-to-heal skin infections but can also trigger life-threatening pneumonias and bloodstream infections.

The spread of MRSA bacteria outside of the walls of hospitals, among people who don't fit the traditional risk profile for acquisition of the bacteria, is seen as an alarming trend by infectious disease experts.

This report doesn't assess the scope of that problem as it only captures community acquired cases where the infection was so severe the patient needed to seek hospital care. People who were cared for by family doctors or in clinics would not be reflected in these numbers.

But the hints it does contain about MRSA outside of hospital settings worries Dr. John Conly, head of the department of medicine at the University of Calgary and a researcher who has been chronicling the spread of community acquired MRSA in that city.

Where a few years ago community acquired MRSA was only seen in the marginalized groups - the homeless, drug users, sex workers and prison inmates - it is now seen further afield, Conly said.

"It's spilled outside of the marginalized groups. We're seeing now probably 20 per cent to 30 per cent where we have no logical explanation" for the infection, he said.

In the United States, where the MRSA problem is more acute, the community strains have started to displace hospital strains in hospitals in some of the hardest hit areas. That phenomenon has started to be seen in Canada, Simor and Conly said, but at this point it's occurring in small clusters.

The report showed that the rate of new MRSA detections in hospitals - which includes both people with MRSA infections and those carrying it without symptoms - was 8.04 per 1,000 hospital admissions. Looked at another way, it was 10.16 cases per 10,000 patient days in hospital.

In 1995, when national data on MRSA was first collected, the rate per 1,000 admissions was less than one per cent. Except for a slight dip in 2001, when the rate was just under four cases per 1,000 admissions, the yearly rate has slowly but relentlessly risen.

Comparing the rates to those seen elsewhere is difficult because of differences in the way data are collected, said Dr. William Jarvis, a U.S. infection control consultant who used to head the division of hospital infections at the Centers for Disease Control in Atlanta.

But the graphs contained in the report tell the tale, he said.

"If the numbers are going up, you need to do more (in terms of infection control)," Jarvis insisted.

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