Plagues, Pestilences and Diseases
10 August 2010 Last updated at 20:06 ET
New 'superbug' found in UK hospitals
By Michelle Roberts Health reporter, BBC News
E. coli NDM-1 has been found in E.coli bacteria
BBC - A new superbug that is resistant to even the most powerful
antibiotics has entered UK hospitals, experts warn.
They say bacteria which make an enzyme called NDM-1 travelled back with
NHS patients who had gone abroad to countries like India and Pakistan
for treatments such as cosmetic surgery.
Although there have only been about 50 cases identified in the UK so
far, scientists fear it will go global.
Tight surveillance and new drugs are needed says Lancet Infectious
Diseases.
NDM-1 can live inside different bacteria, like E.coli, and it makes
them resistant to one of the most powerful groups of antibiotics -
carbapenems.
These are generally reserved for use in emergencies and to combat
hard-to-treat infections caused by other multi-resistant bacteria.
The fear would be that it gets into a strain of bacteria that is
very good at being transmitted between patients”
And experts fear NDM-1 could now jump to other strains of bacteria that
are already resistant to many other antibiotics.
Ultimately, this could produce dangerous infections that would spread
rapidly from person to person and be almost impossible to treat.
At least one of the NDM-1 infections the researchers analysed was
resistant to all known antibiotics.
Similar infections have been seen in the US, Canada, Australia and the
Netherlands and international researchers say that NDM-1 could become a
major global health problem.
Infections have already been passed from patient to patient in UK
hospitals.
The way to stop NDM-1, say researchers, is to rapidly identify and
isolate any hospital patients who are infected.
Normal infection control measures, such as disinfecting hospital
equipment and doctors and nurses washing their hands with antibacterial
soap, can stop the spread.
And currently, most of the bacteria carrying NDM-1 have been treatable
using a combination of different antibiotics.
But the potential of NDM-1 to become endemic worldwide is "clear and
frightening", say the researchers in their Lancet paper.
National alert
Dr David Livermore, one of the researchers and who works for the UK's
Health Protection Agency (HPA), said: "There have been a number of
small clusters within the UK, but far and away the greater number of
cases appear to be associated with travel and hospital treatment in the
Indian subcontinent.
E. coli E. coli can cause urinary tract infections and blood poisoning
"This type of resistance has become quite widespread there.
"The fear would be that it gets into a strain of bacteria that is very
good at being transmitted between patients."
He said the threat was a serious global public health problem as there
are few suitable new antibiotics in development and none that are
effective against NDM-1.
The Department of Health has already put out an alert on the issue, he
said.
"We issue these alerts very sparingly when we see new and disturbing
resistance."
Travel history
The National Resistance Alert came in 2009 after the HPA noted an
increasing number of cases - some fatal - emerging in the UK.
The Lancet study looked back at some of the NDM-1 cases referred to the
HPA up to 2009 from hospitals scattered across the UK.
At least 17 of the 37 patients they studied had a history of travelling
to India or Pakistan within the past year, and 14 of them had been
admitted to a hospital in these countries - many for cosmetic surgery.
For some of the patients the infection was mild, while others were
seriously ill, and some with blood poisoning.
A Department of Health spokeswoman said: "We are working with the HPA
on this issue.
"Hospitals need to ensure they continue to provide good infection
control to prevent any spread, consider whether patients have recently
been treated abroad and send samples to HPA for testing.
"So far there has only been a small number of cases in UK hospital
patients. The HPA is continuing to monitor the situation and we are
investigating ways of encouraging the development of new antibiotics
with our European colleagues."