Doctors could, in the near future, be regularly confronted with hospital types of Escherichia coli bacteria causing infections in patients in community settings, a scenario similar to that of community-acquired meticillin-resistant Staphylococcus aureus (MRSA). These are the conclusions of authors of a Review published in the March edition of The Lancet Infectious Diseases.
Urinary tract infections are common manifestations of these strains of E coli, however recent reports have also described certain antibiotic resistant E coli strains as a cause of bloodstream infections.
Dr Johann Pitout, Calgary Laboratory Services, Calgary, and University of Calgary, Alberta, Canada and Dr Kevin Laupland, University of Calgary, Alberta, Canada, say that the antibiotic-resistant E coli bacteria causing these infections must be rapidly identified to help minimise their spread and to help select more effective antibiotics.
The Review centres on the types of E coli which produce β lactamases -- it is these β lactamases that help give the E coli their antibiotic resistance. Alarmingly, several surveys since 2000 from various European countries (including UK, Spain, Italy, Greece, and Canada) have shown a trend of E coli developing co-resistance to a variety of antibiotics.
The authors say: "Infection control practitioners and clinicians need the clinical laboratory to rapidly identify and characterise different types of resistant bacteria efficiently to minimise the spread of these bacteria and help select more appropriate antibiotics….these bacteria have become widely prevalent in the community setting in certain areas of the world and they are most likely being imported into the hospital setting."
The authors recommend that international funding be directed to track and monitor the worldwide spread of these resistant E coli within the hospital and community settings. They conclude by discussing the possible future risk that the recent trend of bloodstream infections in the community caused by these drug-resistant bacteria, particularly types of β lactamase producing E coli, presents. They say: "These infections are currently rare, but it is possible that, in the near future, clinicians will be regularly confronted with hospital types of bacteria causing infections in patients from the community, a scenario very similar to that of community-acquired MRSA."
Dr Johann Pitout, Calgary Laboratory Services, Calgary, and University of Calgary, Alberta, Canada T) +1 (403) 770 3573 / +1 (403) 770 3309 / mobile +1 (403) 710 4004 E) Johann.Pitout@CLS.ab.ca
http://www.eurekalert.org/jrnls/lance/TLIDenterobacteriae.pdf
Journal
The Lancet Infectious Diseases