A new superbug found in Britain is major concern: Government scientists
A new superbug that is resistant to all antibiotics has been brought into Britain by patients having surgery abroad, Government scientists said.
By Rebecca Smith, Medical Editor
Published: 9:00AM BST 08 Aug 2009
A new superbug that is resistant to all antibiotics has been brought into Britain by patients having surgery abroad, Government scientists said.
Doctors are urged to be vigilent for a new bug that has arriving in Britain with patients who have travelled to India and Pakistan for cosmetic surgery or organ transplants and is now circulating here.
So far there have been 22 cases in 17 hospitals Britain and the Health Protection Agency has said its emergence here is a 'major concern'.
The HPA has found the enzyme that destroys antibiotics in patients with infections caused by E.coli and other bacteria.
The enzyme, called New Delhi Metallo-1, has so far been found attached to bacteria that has caused urinary tract infections and respiratory infections.
It is of particular concern because it can jump from one strain of bacteria to another meaning it could attach itself to more dangerous infections that can cause severe illnesses and blood poisoning making them almost impossible to treat.
The NDM-1 enzyme destroys a group of antibiotics called carbapenems which are mainly used in Britain for severe infections and are tightly controlled because they are one of the few groups of antibiotics that remain useful against bacteria that have already developed resistance to the commonly used drugs.
Experts at the HPA are now investigating old antibiotics that have fallen out of use, new ones in development and drugs used in other countries to see if any work against bacteria producing the NDM-1 enzyme. Two have been found that are of limited use against the new bug.
Dr David Livermore, director of the HPA's Centre for Infection's Antibiotics Resistance and Monitoring Reference Laboratory, said: "Carbapenems have had to be used more and more as bacteria have become resistant to antibiotics. Therefore it is a worry when we see carbapenem resistance emerging. Increasingly over the last year we have seen small numbers that can destroy carbapenems.
"Because the enzyme can move from bacteria to bacteria the fear has to be that it would get into a strain that is good at causing severe infections. I would be very concerned if it got into an E.coli strain that was associated with severe infection.
"That is what happened with MRSA, in the 1980s in Britain they were not successful strains and did not cause severe infections, but by the 1990s it caused severe infections and became a very major public health issue."
Dr Livermore said all patients in hospital should ensure staff and visitors wash their hands to prevent the spread of any infection and anyone who has had treatment abroad should ensure their doctors here know about it.
He also urged anyone travelling abroad for medical treatment to ask about the infection risks and possible resistance.
Antibiotics are widely available to buy without prescription in India and Pakistan and this has meant hospital doctor there have had to resort to more powerful drugs to clear infections, in turn leading to more resistance developing.
With increasing medical tourism between Britain and Asia, 'more and more' antibiotic resistant strains will be imported into this country, he warned. Similar carbapenem destroying bugs have also been imported by patients having treatment in Cyprus, Israel and Greece.
One British patient, who developed a bloodstream infection with an E coli that produced NDM-1 enzyme had received treatment for cancer in both India and the UK; two others had undergone cosmetic surgery in India and others had received renal or liver transplantation in Pakistan.
However ten cases in Britain had not reported any foreign medical treatment.
A bulletin from the HPA said: "Treatment presents major challenges. Most isolates with NDM-1 enzyme are resistant to all standard intravenous antibiotics for treatment of severe infections.
"Great care should be taken to prevent onward transmission. Comprehensive infection control advice can be provided by the HPA's Laboratory of Healthcare-Associated Infection but key aspects include isolation of sources and screening of cases and close hospital contacts."
A new superbug that is resistant to all antibiotics has been brought into Britain by patients having surgery abroad, Government scientists said.
By Rebecca Smith, Medical Editor
Published: 9:00AM BST 08 Aug 2009
A new superbug that is resistant to all antibiotics has been brought into Britain by patients having surgery abroad, Government scientists said.
Doctors are urged to be vigilent for a new bug that has arriving in Britain with patients who have travelled to India and Pakistan for cosmetic surgery or organ transplants and is now circulating here.
So far there have been 22 cases in 17 hospitals Britain and the Health Protection Agency has said its emergence here is a 'major concern'.
The HPA has found the enzyme that destroys antibiotics in patients with infections caused by E.coli and other bacteria.
The enzyme, called New Delhi Metallo-1, has so far been found attached to bacteria that has caused urinary tract infections and respiratory infections.
It is of particular concern because it can jump from one strain of bacteria to another meaning it could attach itself to more dangerous infections that can cause severe illnesses and blood poisoning making them almost impossible to treat.
The NDM-1 enzyme destroys a group of antibiotics called carbapenems which are mainly used in Britain for severe infections and are tightly controlled because they are one of the few groups of antibiotics that remain useful against bacteria that have already developed resistance to the commonly used drugs.
Experts at the HPA are now investigating old antibiotics that have fallen out of use, new ones in development and drugs used in other countries to see if any work against bacteria producing the NDM-1 enzyme. Two have been found that are of limited use against the new bug.
Dr David Livermore, director of the HPA's Centre for Infection's Antibiotics Resistance and Monitoring Reference Laboratory, said: "Carbapenems have had to be used more and more as bacteria have become resistant to antibiotics. Therefore it is a worry when we see carbapenem resistance emerging. Increasingly over the last year we have seen small numbers that can destroy carbapenems.
"Because the enzyme can move from bacteria to bacteria the fear has to be that it would get into a strain that is good at causing severe infections. I would be very concerned if it got into an E.coli strain that was associated with severe infection.
"That is what happened with MRSA, in the 1980s in Britain they were not successful strains and did not cause severe infections, but by the 1990s it caused severe infections and became a very major public health issue."
Dr Livermore said all patients in hospital should ensure staff and visitors wash their hands to prevent the spread of any infection and anyone who has had treatment abroad should ensure their doctors here know about it.
He also urged anyone travelling abroad for medical treatment to ask about the infection risks and possible resistance.
Antibiotics are widely available to buy without prescription in India and Pakistan and this has meant hospital doctor there have had to resort to more powerful drugs to clear infections, in turn leading to more resistance developing.
With increasing medical tourism between Britain and Asia, 'more and more' antibiotic resistant strains will be imported into this country, he warned. Similar carbapenem destroying bugs have also been imported by patients having treatment in Cyprus, Israel and Greece.
One British patient, who developed a bloodstream infection with an E coli that produced NDM-1 enzyme had received treatment for cancer in both India and the UK; two others had undergone cosmetic surgery in India and others had received renal or liver transplantation in Pakistan.
However ten cases in Britain had not reported any foreign medical treatment.
A bulletin from the HPA said: "Treatment presents major challenges. Most isolates with NDM-1 enzyme are resistant to all standard intravenous antibiotics for treatment of severe infections.
"Great care should be taken to prevent onward transmission. Comprehensive infection control advice can be provided by the HPA's Laboratory of Healthcare-Associated Infection but key aspects include isolation of sources and screening of cases and close hospital contacts."
