Hong Kong urged to tackle superbug problem by making hospitals disclose infection and drug data

Microbiologist says more stringent measures will only be adopted if infection rates and prescription of antibiotics are under public scrutiny

PUBLISHED : Sunday, 02 April, 2017, 5:39pm
UPDATED : Wednesday, 05 April, 2017, 3:05pm

A leading microbiologist warns Hong Kong is “lagging behind” in combating the spread of superbugs and says pressure should be put on public hospitals by making them disclose the number of cases and their use of antibiotics.

Hospital chiefs would then be obliged to tackle the problem, linked to doctors who too freely hand out the drugs.

Professor Yuen Kwok-yung said when this was done in Britain, cases of methicillin-resistant Staphylococcus aureus (MRSA) fell by about 90 per cent within 10 years. The superbug can infect different parts of the body and has been under World Health Organisation surveillance.

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The recommendation by Yuen, chair of infectious diseases at the University of Hong Kong and a government adviser on the issue, comes ahead of a meeting late this month by the government’s steering committee on antimicrobial resistance, headed by health minister Dr Ko Wing-man, to discuss expert proposals.

Yuensaid hospitals would only adopt more stringent measures if the prescription of antibiotics and the number of infections were under public scrutiny.

“Pressure could be exerted only if hospitals are named. Hospital heads would then take action [to tackle the problem],” he said.

The use of large amounts of antibiotics might indicate abuse of the drugs, which could kill both the bad and good germs in the body and promote the growth of antibiotic-resistant bacteria.

In 2014 in Britain, 11 per cent of Staphylococcus aureus cases were MRSA, in contrast to 48 per cent in Hong Kong.

The city also recorded a 47 per cent rate of Acinetobacter cases that were resistant to carbapenem, another superbug given a “critical” priority by the WHO, compared with just 2 per cent in Britain.

I’m not very optimistic. It is way too severe
Professor Yuen Kwok-yung, HKU

“I’m not very optimistic [about resolving the problem quickly]. It is way too severe,” Yuen said.

The Hospital Authority in Hong Kong discloses the overall number of different types of drug-resistant bacteria cases in public hospitals every year. Individual hospitals only publish details on two of a dozen common superbugs weekly and quarterly; they do not disclose consumption of antibiotics.

“If we want private doctors to [disclose antibiotics usage], why don’t public hospitals do it too?” asked Yuen.

While the Department of Health conducted a survey in 2012 covering more than 1,700 doctors to understand their pattern of antibiotics use, the latest information remained opaque to the public.

Yuen also suggested health authorities engage the parents of kindergarten and primary school children, who visit doctors more often, in tackling the issue.

Parents could take photos of packets of medication prescribed to children and send them to the Department of Health or a university for research purposes.

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“Then we would know the prescription rate [among private doctors] ... we won’t simply judge from the figures, but at least we would get hold of the situation,” Yuen said, adding that authorities and researchers currently knew nothing about the prescription patterns of private doctors.

He said up to 80 per cent of children fell sick with upper respiratory tract infections, but only 10 to 20 per cent of cases were caused by bacteria that should be treated with antibiotics.

Enhancing food safety could also reduce superbugs, Yuen said. He proposed placing a warning on restaurant menus to remind customers of the risk of contracting superbugs or infections when eating uncooked food such as oysters or sushi.

A spokesman said the authority would constantly review practices to ensure the policy on disclosure met public expectations.

The Department of Health said it was reviewing data collected on antibiotics consumption through different channels for the purpose of monitoring.