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Drug Resistant E. Coli Poised to Become a Big Problem

Feb 21, 2008 | Parker Waichman LLP

Drug Resistant E. coli bacteria are spreading beyond hospitals into the greater population, Canadian scientists have warned, and global health officials need to begin monitoring the spread of drug resistant E. Coli.  Those conclusions where draw from a study of drug resistant E. coli conducted by  Dr. Johann Pitout and Dr. Kevin Laupland, both from the University of Calgary in Canada.  For the study, the scientists looked at a strain of E. coli that produces extended-spectrum beta lactamases or ESBLs, enzymes that give the bacteria resistance to antibiotic drugs.

Escherichia coli is a relatively common bacteria found in the human gut—or digestive tract—and is normally harmless; however, some strains, including those linked to food poisoning, are serious and can cause fatal blood poisoning, cystitis, and deadly septicemia.  The elderly are most at risk, particularly those living in nursing homes.

Several countries now report cases of antibiotic-resistant E.coli and health officials are particularly concerned about the drug-resistant strains reported in Spain, Israel, Italy, Greece, the UK, and Canada.  In these cases, the infection was resistant to four key antibiotics.  In Britain, BBC News reported blood poisoning cases caused by E. coli more than doubled in the ten-year period from 1995 to 2005; a small but growing number were drug-resistant.  In a review of 54 deaths in the county of Shropshire, England all patients were sickened with the resistant strain; the toxin directly contributed to 20% of the deaths.  The bacterium was also responsible for a severe outbreak of urinary tract infections between 2003 and 2004. The UK's Health Protection Agency (HPA) said it has been investigating these infections for several years.

Researchers compared the E.coli threat to community-acquired MRSA, which is emerging as a public health problem in many parts of the world, including the US.  MRSA—or methicillin-resistant Staphylococcus aureus—is an antibiotic-resistant staph developing resistance to the last drug of choice.  In the U.S., community-acquired MRSA is spread outside medical facilities through skin-to-skin contact and accounts for 12% of MRSA cases.

E. coli infections "are currently rare, but it is possible, in the near future, clinicians will be confronted with hospital types of bacteria causing infections in patients from the community—a scenario very similar to that of community-acquired MRSA," the scientists wrote.  "We agree with the authors that antibiotic resistance is an important issue affecting public health,” the U.K.’s HPA said in a BBC News report.  "There is a need for sustained research into both the origin of these E.coli strains as well as the number of people who carry ESBL-producing E.coli in their gut, to help gain a better understanding of the risk factors for people acquiring infections; how they are transmitted and to help develop better control measures."  

Dr. Andrew Berrington of Sunderland Royal Hospital said, "It does seem to be true that what was previously regarded as a hospital problem is now being seen in the community as well.  These bacteria are not, as far as is known, excessively virulent, but they are becoming more resistant to antibiotics and, therefore, harder to treat."


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