1. Confirmed cases: Deaths:

2. Villain NOT superhero…..

3. What are superbugs? Bacteria that carry genes that allow them to survive exposure to the antibiotics we currently have! Infections caused by these bacteria are therefore very difficult to treat The genes that carry antibiotic resistance can be passed between bacteria, with the potential for new bacteria to be resistant to several different antibiotics which = superbugs!

4. How does a bacteria turn into a superbug? Think Evolution…..survival of the fittest….. If you were a bacteria…you would try your hardest to stay alive….those that are successful at doing so pass this ability (their genes) on to their offspring The more exposure to antibiotics the better they become at resisting it..

5. Two ways bacteria become antibiotic resistant (Naturally) 1) Genetic Mutation – Rare spontaneous changes to the bacteria’s genetic information 2) Acquiring resistance from other bacterium - Through reproduction bacteria swap genetic information

6. Some ways bacteria become antibiotic resistant (human induced) 1. Unnecessary use of antibiotics by humans 2. Use in animal feeds in low doses 3. Misuse by health professionals 4. Patient failure to follow prescribed course of treatment (e.g. they stop taking the antibiotics before prescription is finished) 5. Antibiotic application in agriculture, aquaria and family pets

8. Examples of Superbugs Clostridium difficile are bacteria that naturally grow in our intestines. They become a problem when they overpopulate our intestines and drive other helpful bacteria out.

9. How does one develop a C.Difficile infection? Taking antibiotics (for an infection or to prevent infection from surgery etc.) kills off some of the helpful bacteria in our intestines C.Difficile bacteria over populate and they can release toxins that can cause bloating, constipation, diarrhea, and abdominal pain

10. How is it transmitted? C. difficile bacteria are found in feces. Enters body through Fecal-oral route Healthcare workers can spread the bacteria to their patients if their hands are contaminated.

11. Who is at risk? Healthy people don’t usually get C. difficile. People who have other illnesses or conditions requiring the use of antibiotics and the elderly are at greater risk of infection. Patients in a hospital or long-term care facility where a C.Difficile outbreak occurs

12. Why should we be concerned? C. difficile is resistant to most antibiotics. It is the start of what many scientists believe will be a string of antibiotic resistant bacteria. In some cases the dehydration caused by C. difficile can be fatal.

13. When did it become a problem? In June of 2003, it was diagnosed in hospitals in Calgary and Montreal. By the end of 2004, 1400 cases were documented (mainly in Quebec) and 89 people died. In 2005 it showed up in the Toronto area and outbreaks have been recorded every year since at hospitals or long-term care facilities.

14. The latest outbreak? Friday April 12, 2013: 2 cases of hospital- transmitted C. difficile confirmed in Newfoundland For more information visit this link: http://www.ctvnews.ca/can ada/2-cases-of-hospital- transmitted-c-difficile- confirmed-in- newfoundland- 1.1235401#ixzz2QH7aWl cI http://www.ctvnews.ca/can ada/2-cases-of-hospital- transmitted-c-difficile- confirmed-in- newfoundland- 1.1235401#ixzz2QH7aWl cI

15. C.difficile seems to be back on the rise in Quebec…. C. difficile-related deaths since 2004 in Quebec 2004-2005 – 1,034 2005-2006 – 522 2006-2007 – 561 2007-2008 – 335 2008-2009 – 457 2009-2010 – 478 2010-2011 – 619 (Source: INSPQ report)

16. What was PHAC’s response? PHAC has been surveying hospitals and long-term care facilities since 2003. It has put out a guideline for C. difficile. It has put into place, guidelines for healthcare workers and laboratory workers for dealing with infectious patients and biohazardous materials (i.e. feces).

17. How do we protect ourselves from getting C. difficile? Hand washing! When visiting health care facilities wash/sanitize hand when you enter and exit When taking antibiotics eat probiotics (yogurt) to replenish your helpful bacteria

18. C. difficile treatment Mild cases may not require treatment - just wait out the return of the healthy bacteria to your intestines More severe cases may be treated with antibiotics (a bit ironic yes) is needed (i.e. Metronidazole) Fecal transplants are a new controversial treatment option

19. Other “Super Bugs” VRE: Vancomycin Resistant Enterococcus Can cause urinary tract infections and various nasty things including meningitis. MRSA: Methicillin Resistant Staphylococcus aureus. Skin and soft tissue can become infected and pus filled boils and holes can occur Can lead to “flesh-eating” disease and toxic shock. VRE destroying lung tissue

21. Superbugs in the supermarket! http://www.cbc.ca/marketplace/2011/superbugsi nthesupermarket/ http://www.cbc.ca/marketplace/2011/superbugsi nthesupermarket/ Complete the questions as we watch this CBC Marketplace episode which aired in February 2011