Dr. Michael O'Dwyer:

There are so many elements that go into it. There are patient-specific factors, such as their immune systems, comorbidities and genetics. There are also factors specific to the organism. Some strains are more virulent than others, like the group A streptococci. We have brought this matter up with the committee before. Then there are the institutional factors that we have talked about time and time again, such as antimicrobial resistance. If a person is in hospital, he or she is more likely to be affected by a resistant organism. That lulls people into a false sense of security because they are on an antibiotic. If, however, the organism is resistant to the antibiotic or if the antibiotic is inappropriate, it is the same as not having an antibiotic for a couple of days. There are many different factors that play into the severity of illness for patients within hospitals.