But despite that, rates of these infections continued to rise in the years immediately preceding the outbreaks, a new study reveals.

Rates of methicillin-resistant Staphylococcus aureus - known as MRSA - more than doubled in the period from 1999 to 2005, said the study, which was based on a survey of Canadian hospitals with more 80 or more patient beds.

Clostridium difficile infections also rose over that period and the number of hospitals reporting new cases of infection with vancomycin-resistant Enterococcus climbed 77 per cent over the period.

"Despite the two major communicable diseases - SARS and C. difficile - despite the emphasis by the Canadian Public Safety Institute on safer health care, despite all those things, our institutional approaches to infection control have changed remarkably little," said Dr. Andrew Simor, head of microbiology at Toronto's Sunnybrook Health Sciences Centre. Simor was not involved in the study.

"And the outcomes, as a result, have gone in the wrong direction."

The survey was conducted in 2006 by researchers from Queen's University in Kingston, Ont., and was a follow-up to an earlier survey conducted in 1999. Both were funded by the Public Health Agency of Canada.

The results, which will be published in the December issue of the American Journal of Infection Control, showed that while hospitals reported an increase in staff devoted to infection control, increasing numbers of patients fell prey to hospital-acquired infections.

There were 5.2 cases of MRSA per 1,000 hospital admissions in 2005, up from two per 1,000 in 1999. There was also an upward trend in C. difficile infections, and the number of hospitals reporting new cases of infection with VRE soared.

"We have to roll up our sleeves," said lead author Dr. Dick Zoutman, head of infection control at Kingston General Hospital.

But while the numbers don't look good, the director of infectious disease prevention and control with Ontario's public health agency raised a couple of important caveats.

Dr. Michael Gardam suggested hiring new infection control staff is only one step in improving a hospital's infection control performance. Real improvement requires a commitment and effort from all those involved in patient care in an institution, he said - and that takes time.

"Rome wasn't built in a day," Gardam said.

"You need to have more infection control practitioners. And you need to bring about culture change. And just doing the resources side of things I don't believe will actually get you there."

Gardam also suggested the numbers might have been worse but for the injection of resources that followed the 2003 SARS outbreak and the C. difficile crisis, which first came to light in 2004.

"Probably we are having an impact, we are slowing the increase," said Gardam, who was not involved in the study. "But we're not actually achieving a real steady state and we're not actually seeing a decrease."

That's especially worrying given the current state of the economy, said both Zoutman and Simor, who noted that infection control efforts are an easy target when hospitals are trying to cut costs.

"I'm concerned now that it's more challenging economic times ... that we don't lose (sight of) this," said Zoutman.

"Because it's a false economy. It's penny wise, pound foolish."

Copyright The Canadian Press