August 11, 2010

expert reaction to new research on drug-resistant bacteria, as published in the Lancet Infectious Diseases

This paper looked at the development of a new class of drug resistant bacteria.

Prof Kevin G. Kerr, Consultant Microbiologist/Hon Clinical Professor of Microbiology, Harrogate District Hospital, said:

“This investigation highlights the size of the challenge we face in dealing with a new type of resistance in bacteria such as E. coli which are common causes of infection both in hospitals and in the community. The number of antibiotics we have left to treat these superbugs is rapidly diminishing and it is conceivable that we will soon see infections which are effectively untreatable. This report shows that the battle to control the emergence of antibiotic resistant superbugs through appropriate use of antibiotics must be fought at an international level.”

Prof Christopher Thomas, Professor of Molecular Genetics, University of Birmingham, said:

“This research illustrates the relentless evolution and spread of antibiotic resistance genes in bacteria which inevitably follows the development and use of new antibiotics in both clinical and community contexts. The rise of infections (eg urinary tract infections) by bacteria that normally are found in the gut (enteric bacteria) but can create severe problems in the old, infirm or those with weakened defences is partly a side product of advances elsewhere in medicine.

“It illustrates the importance of considering health issues as a world issue – how antibiotics are prescribed and controlled in one part of the world can very rapidly have consequences elsewhere. Understanding the medical, social and environmental factors that drive this evolution and spread should be a major priority to underpin the development of policies to minimise the threat.”

Prof Richard James, Director of the Centre for Healthcare Associated Infections, University of Nottingham, said:

“This work highlights that C.difficile and MRSA are not the only bacteria that can cause us serious harm. Bacteria that produce extended spectrum beta-lactamases (ESBLs) are resistant to the majority of antibiotics, with the possible exception of the carbapenems; this results in an increased therapeutic use of this class of antibiotics.

“This research describes the detection of the recently described NDM-1 ESBL in bacterial isolates obtained from patients in a number of locations in India and the UK. NDM-1 is the third type of carbapenemase, an ESBL that encodes resistance to carbapenems, that has been identified. NDM-1 was first detected in the UK in 2008 and has already become the predominant carbapenemase. At least 17 of the 29 UK patients infected by an NDM-1 producing bacteria had a history of travel to India. There is evidence of a link to the growing practice of medical tourism.

“The NDM-1 strains in the UK were largely unrelated to each other indicating that this ESBL resistance gene is capable of dissemination to a variety of pathogenic bacteria and thus constitutes a serious threat to healthcare systems. The detection of NDM-1 in the UK resulted in the release of a National Resistance Alert 3 notice by the Department of Health in 2009.”

‘Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study’, Walsh et al, published in the Lancet Infectious Diseases, Wed 11 Aug 2010.