A DEADLY superbug that has swept through Europe and North America has arrived in Australia, but experts fear it is being missed because of inadequate testing.
Specialised labs are finding highly toxic strains of Clostridium difficile, also known as C diff, more often, but the extent of the problem is unknown because the strains are not the subject of routine testing.
An audit of one local health district found up to 40 per cent of serious cases were missed.
Thomas Riley, a professor of microbiology at the University of Western Australia, said his lab saw a dramatic increase in the C diff strain known as 244 towards the end of last year.
No deaths have been linked to C diff in NSW, but in May Victoria's Chief Health Officer, Rosemary Lester, revealed that 14 Victorians had died after picking it up in hospitals and aged-care facilities over a 15-month period in 2010 and 2011.
Professor Riley said 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 5 per cent of tested cases.
Professor Riley said routine testing of C diff strains was urgently needed.
Part of the problem was that while infectious bacteria were commonly spread among patients in hospital, C diff seemed to be spreading throughout the community and it was not known why, although he suspected imported food could be responsible.
Superbug strains of C diff are more widespread in North America and Europe. Between 6 and 30 per cent of infected patients die from it and deadly cases are increasingly common, data published by the US Centres for Disease Control and Prevention show.
The public health director at the Centre for Infectious Diseases and Microbiology, Lyn Gilbert, said testing varied between districts and did not always look for superbug strains, but there appeared to be an increase of infections that were linked to the 244 strain.
“It has appeared really from nowhere sometime last year and it’s been seen in all the Australian states,’’ 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 picked up through food, she said.
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 found while 60 C diff cases were identified over 18 months, the actual number was likely to have been closer to 100 as many patients were not tested, research presented at the Australasian College for Infection Prevention and Control Conference last week showed.
About half the cases appeared to have been spread through the community, while the rest were picked up in hospital.
A spokeswoman for the NSW Clinical Excellence Commission said the Ministry of Health had not received any notifications of hypervirulent strains of C diff this year, although hospitals were not required to report cases of the 244 strain.
‘‘There has been some suggestion 244 may be hypervirulent but there is no published literature to support this as a formal finding,’’ she said.
In November the Australian Commission on Safety and Quality in Healthcare will run a C diff prevalence survey that will involve NSW hospitals and the commission would continue to monitor it, she said.