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New Drug-Resistant Bug Causes Concern In UK Hospitals

Posted on: Tuesday, 18 November 2008, 15:05 CST

Infection control experts are warning hospitals to be vigilant against an emerging drug-resistant bacterium called Acinetobacter baumannii.

Experts say the bacterium poses the greatest risk to seriously ill patients and that the infection was a growing public health worry across the world

Lancet Infectious Diseases reported that rates of resistance to antibiotics that halt the bug currently stand at 30%.

Experts said measures in the UK to control MRSA and other "hospital-acquired infections" like Clostridium difficile should also bring down Acinetobacter rates.

Acinetobacter shares many of the "superbug" properties of MRSA and Clostridium difficile, such as survival on surfaces and resistance to disinfectants. Experts say this makes it difficult to eradicate from wards once it is there.

The bacterium typically causes bloodstream infections, pneumonia or infection of a wound. The infection can be carried on the skin of healthy people and can be passed to patients by poor hand hygiene.

It can also survive in dust and on objects such as bedding for months, making rigorous cleaning of wards essential to control its spread.

Luckily, the bug does not usually pose a threat to healthy people and the strains of Acinetobacter that are resistant to standard treatments can be treated with other antibiotics.

The report, by Professor Matthew Falagas and Dr. Drosos Karageorgopoulos, of the Alfa Institute of Biomedical Sciences in Athens, Greece, said strict hygiene compliance and more thorough research into drug choice, especially those for multidrug-resistant Acinetobacter baumannii, are vital to prevent major outbreaks.

The numbers of Acinetobacter bloodstream infections reported in the UK to the Health Protection Agency via its voluntary surveillance scheme increased by 5.4% between 2003 and 2007 to 1,187 reports.

But the increase could be due to increased awareness and reporting rather than a true rise in infection rates, according to the HPA.

“Acinetobacter can cause problems in those who are already seriously ill with weakened immune systems,” said a spokeswoman for the Health Protection Agency.

"Although we do see some outbreaks of this infection in the UK, numbers of cases are fortunately small.

"Transmission of this infection can be reduced by careful attention to infection control procedures such as cohort nursing groups, hand hygiene and environmental cleaning. It is important that trusts remain vigilant in their treatment of this and all healthcare associated infections."

The HPA currently has no plans to make the reporting of cases mandatory, largely because it is not deemed to be as great a threat as the notifiable hospital-acquired infections such as MRSA and C.difficile.

“If we could overnight solve the problems of hospital infections caused by C.difficile and MRSA then there are other potential superbugs like Acinetobacter baumannii lying in wait,” said Professor Richard James, director of the Centre for Healthcare Associated Infections at Nottingham University.

"Hospitals are full of sick patients and very fit bacteria that will spread from patient to patient unless infection control measures are up to the challenge.

"Acinetobacter baumannii, multidrug resistant tuberculosis (MDR-TB) and extremely drug resistant tuberculosis (XDR-TB) are examples of new threats to public health that are already causing serious problems in other countries."

But there is little evidence to suggest outbreaks of Acinetobacter were becoming more common in the UK, according to Dr. Andrew Berrington, a consultant microbiologist at Sunderland Royal Hospital.

"We mustn't be complacent but currently its impact can be geographically constrained - some hospitals struggle to control outbreaks, others see very little of it."

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Image Caption: A scanning electron micrograph (SEM) of a highly magnified cluster of Gram-negative, non-motile en:Acinetobacter baumannii bacteria; Mag - 13331x.

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On the Net:

• Health Protection Agency
• Lancet Infectious Diseases

Source: redOrbit Staff & Wire Reports

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