Infection Watch

Infection By Deadly Bacterium Can Be Prevented With Proper Sanitation

Link: Global Risk - Infection By Deadly Bacterium Can Be Prevented With Proper Sanitation.

As urban sprawl spreads throughout the globe, so do poor urban ghettos and the infectious diseases that are perpetrated by unsanitary slum conditions. Weill Cornell researchers stationed in the urban slums of Salvador, Brazil, have discovered that certain unhealthy living conditions lead to transmission of leptospirosis, a life-threatening disease caused by the bacterium Leptospira. Over a half-million people are infected, killing 1 in 10, each year. The disease, which is characterized by fever, abdominal pain, and can lead to severe pulmonary bleeding, kidney damage and meningitis, is transmitted through animal contact (commonly rat urine).

Dr. Albert Ko, senior author of the study and physician-scientist from the Division of International Medicine and Infectious Disease at Weill Cornell Medical College, and his research team stationed at Oswaldo Cruz Foundation/Brazilian Ministry of Health in the city of Salvador, tested a group of 3,171 slum residents for Leptospira antibodies - a marker of past infection with the bacterium.

New superbug strikes 70 in Wales

Link: New superbug strikes Wales - icWales.

MORE than 70 Welsh patients have caught a new superbug which is resistant to virtually all antibiotics, Wales on Sunday can reveal.

There is growing concern across the UK that antibiotic-resistant infections caused by the bug Stenotrophomonas maltophilia – known as Steno – are on the increase.

But Welsh health experts have been quick to stress that such cases are rare compared to those caused by the superbug MRSA and E.coli.

Doctors studying the genetic code of Steno are worried about its ability to shrug off all but a couple of antibiotics.

But Dr Robin Howe, a consultant microbiologist, said Steno – which is found naturally in the environment – is not “another killer superbug”.

Dr Howe, head of the Welsh antimicrobial resistance programme for the National Public Health Service, said: “Stenotrophomonas is an environmental bacteria that is found everywhere – it has even been found in Antarctic ice cores. Interestingly, it is actually used on golf putting greens to get rid of brown-patch fungus.

Steno superbug has been here for over a decade

Link: Steno superbug has been here for over a decade - Health - Belfast Telegraph.

A dangerous superbug that clings to catheters and ventilation tubes has already struck hundreds of patients in Northern Ireland, it can be revealed today.

The Communicable Disease Surveillance Centre for Northern Ireland confirmed to the Belfast Telegraph that it has recorded 214 cases over the past decade of a little-known drug-resistant microbe called Steno.

Experts in England this week added the microbe to what they described as an " ever-increasing list of antibiotic-resistant hospital superbugs" which also includes the likes of MRSA and Clostridium Difficile.

The development came after doctors studying its genetic code announced they were worried about its ability to shrug off antibiotics.

Around 1,000 cases of blood poisoning caused by Stenotrophomonas maltophilia are reported in the UK each year. Of these, almost a third are fatal. Although Steno infections are still relatively uncommon, they are on the increase, say the experts.

The surveillance centre is based at Belfast City Hospital and monitors changes in the incidence, prevalence and patterns of communicable disease in the province.

The unit's director, Dr Brian Smyth, confirmed that it has received 214 blood stream infection reports of the Steno organism between 1999 and 2007. He said there was no indication that cases are on the rise in Northern Ireland in line with England.

"Generally, there are between 20 and 30 reports annually with little discernable trend. Therefore it is not a particularly common infection," he said.

The new superbug ..are you at risk?

Link: The new superbug ..are you at risk? - Mirror.co.uk.

How does it kill?

Like many bacteria that infect the blood, Steno produces a toxin which damages all the vital organs of the body including the heart and kidneys. Without successful treatment the organs gradually fail.

How do I know if I've got it?

The first symptom of a Steno bloodstream infection is fever. People who are sent home with catheters still in them are told to look out for this symptom, as are their family. At the first sign of a fever, they should immediately get medical help. Patients in hospitals are monitored closely for symptoms by medical staff.

Can you protect yourself?

Any tubes inserted into the bodies of long-term patients must be regularly inspected, and it is vital they are not contaminated.

If tubes become contaminated they should be replaced with new, sterile ones. However, there is no evidence of Steno spreading between patients.

How is it be treated?

Normally, the antibiotic Co-trimoxazole is used to treat a Steno infection and this generally works unless the strain is resistant, which is currently very rare in the UK.

Q&A: Steno superbug

Link: Q&A: Steno superbug | Society | guardian.co.uk.

What is this new superbug? Stenotrophomonas maltophilia, or Steno, is a bacterium that thrives in moist environments such as taps and shower heads and is difficult to remove by normal cleaning. The bug can pose a serious risk to weak or frail hospital patients if it grows on medical equipment. Why is it in the news? A team of scientists from Bristol University and the Wellcome Trust Sanger Institute, Cambridgeshire, has found Steno has the capacity to rapidly develop drug resistance. The researchers found some strains of Steno are resistant to all available antibiotics, making it at least as hard to treat as the two deadliest superbugs, MRSA and Clostridium difficile (C diff).

40% surge in cases of superbug that is harder to tackle than MRSA

Link: Surge in cases of superbug that is harder to tackle than MRSA | the Daily Mail.

Stenotrophomonas maltophilia, or Steno, thrives in the black 'gunk' that lines shower heads and taps. It kills around 300 Britons a year.

Some strains of the bug are resistant to all available antibiotics, making it harder to treat than the highly-publicised MRSA and C diff infections.

Superbug

Cases of a hospital superbug more difficult to treat than MRSA have soared by 40%

With the number of cases in British hospitals rising by around 40 per cent between 2001 and 2006 to around 1,000 a year, scientists say there is an urgent need to find new ways to combat it.

Two other superbugs identified

Link: Cambridge scientists getting to grips with new superbug - News - Academia and Research - Business Weekly.

Dr Lisa Crossman from the Sanger Institute and first author on the paper explained how the research might address these questions: "The genome sequence should help us to combat these properties. For example, if we know which proteins allow it to stick to surfaces, we could try to develop biochemical compounds that interfere with this interaction. If we understand its antibiotic resistance mechanisms, we might be able to design inhibitors that block them."

While, fortunately, Steno infections are still relatively uncommon, they are on the increase. Furthermore, there are two other organisms that, like Steno, cause infections by colonising catheters and so on, but are more common.

Dr Avison added: "Genome sequences for these two also exist, and so now we can look at what they all have in common genetically that might explain why they all behave in a similar way in the hospital."

Warning over hospital infection

Link: BBC NEWS | Health | Warning over hospital infection.

Hospitals could face a growing threat from a deadly bacterial infection, warn scientists.

An analysis by the Wellcome Trust Sanger Institute found Stenotrophomonas maltophilia has the capacity to develop drug resistance rapidly.

There are currently less than 1,000 reports of Steno blood poisoning in the UK a year - a third of which are fatal.

But the Genome Biology study warns it may eventually prove harder to treat than superbugs such as MRSA.

The degree of resistance it shows is very worrying
Dr Matthew Avison
University of Bristol

At present, Steno infections are responsible for less than 1% of all healthcare acquired infections.

Most infections are in severely ill patients whose immune systems have already been weakened.

Multi drug resistant bacteria flourishes on catheters

Link: The Genome Of A Newly Emerging Superbug Reveals An Organism With A Remarkable Capacity For Drug Resistance.

Dr Matthew Avison from the University of Bristol, and senior author on the paper said: "This is the latest in an ever-increasing list of antibiotic-resistant hospital superbugs. The degree of resistance it shows is very worrying. Strains are now emerging that are resistant to all available antibiotics, and no new drugs capable of combating these 'pan-resistant' strains are currently in development."

Pan-resistant Steno infections are at least as hard to treat as MRSA and C.diff infections. But although it is common in the environment, Steno infections are rarer than MRSA and C.diff infections and are exclusively hospital-acquired.

Steno flourishes in moist environments, such as around taps and shower heads, and can be transferred to patients. It is distinct in the way it causes infection and can only get into the body via devices such as catheters or ventilation tubes that are left in place for long periods of time. Long-dwelling catheters are used most often for seriously ill patients and some undergoing chemotherapy.

Steno can stick to the catheter and grow into a 'biofilm'. When the catheter is next flushed, the Steno biofilm can enter the patient's bloodstream. If their immune system is impaired (which is often the case in the seriously ill and those undergoing chemotherapy) the organism can multiply and cause septicaemia. The gravity of this situation has been underlined by the new research, since these patients will be treated with antibiotics against which Steno is largely resistant.

Microbial Resistance Towards Antibiotics: Still A Critical Issue

Link: Microbial Resistance Towards Antibiotics: Still A Critical Issue.

ECCMID Opening Press Conference. "The problem of antibiotic resistance continues to grow and this is mainly a consequence of longstanding misuse and abuse of antimicrobial agents", said Prof. Fernando Baquero, Congress President (Hospital Ramón y Cajal, Madrid). Among all the pathogens, methicillin-resistant Staphylococcus aureus (MRSA) is a frequent culprit in infections (mainly respiratory, urinary or skin infections) in hospital settings and nursing homes. Despite this, the general public is unfamiliar with this threat (F. Verhoeven et al. - ECCMID abstract no.1387) and unaware that MRSA can contaminate not only patients' rooms and healthcare workers, but also the environment outside hospitals, including houses or workplaces.

"Bacterial resistance to antibiotics commonly used in children is already a critical problem because we cannot use all the antibiotics commonly available for use in adults for the treatment of children", pointed out Prof. Baquero. Clinicians are particularly concerned about the emergence of hyper-virulent and hyper-resistant strains of Pneumococcus (the pathogen more frequently responsible for ear infections among children), whose epidemiology and interactions with hosts have changed rapidly during recent years. "The relentless rise of resistant bacterial strains will be a critical issue for many years to come as innovative antibiotics are not likely to be developed and marketed, and industrial research facilities on antimicrobial agents are being increasingly shut down" - said Prof. Baquero. "We need to change our attitude towards the clinical use of existing antibiotics, as this has been the main factor in the emergence of resistant organisms". A recent study which analysed all the outpatients oral antibiotic prescriptions in Canada (F. Marra, S. Mak et al. ECCMID abstract no.254 ) seems to reveal a link between antibiotic use and socioeconomic determinants: "this is the proof that variables other than clinical appropriateness are now playing an unacceptable role in antibiotic prescription", concluded Prof. Baquero.