Reasonable Rascal
05-28-02, 23:57
From the Harvard ProMed List. Moderator comments are from same.
RR
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From: ProMED-mail <promed@promedmail.org>
Source: BBC [edited]
<http://news.bbc.co.uk/hi/english/uk/scotland/newsid_2009000/2009028.stm>
New "superbug" found in hospital: the ESBL bacterium can break down antibiotics
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A new "superbug" which can neutralize antibiotics and cause fatal blood poisoning [bacteremia -Mod.LL] has been found at a Lanarkshire hospital. The extended-spectrum beta-lactamases (ESBL) superbug is reported to have claimed the life of one patient at Hairmyres in East Kilbride, one of Scotland's most modern hospitals, which opened in 2001.
A study by consultant microbiologist at Hairmyres, Dr Dugald Baird, found that 41 patients contracted the bacteria -- which produce enzymes that break down common antibiotics -- between July 2001 and April 2002. Lanarkshire Acute Hospitals NHS Trust has refused to confirm that a patient had died as a result of the bacteria.
The report, published by the Scottish Centre for Infection and Environmental Health <http://www.show.scot.nhs.uk/scieh/PDF/weekly_report.pdf>, claims it could become the new MRSA (methicillin resistant _Staphylococcus aureus_), a superbug because it is particularly resistant to antibiotics.
Last month, cardiac surgery at Edinburgh Royal Infirmary was halted after it emerged that 13 patients had contracted the superbug [an ESBL or MRSA? - Mod.LL]. Dr Baird said "Initially a lot of the MRSA bacteria were not thought to be very harmful and it may be that we are seeing a similar sort of thing with ESBL producers [The term "superbugs" reflects the antimicrobial resistance pattern and the organism may be about equal to or less pathogenic than its sensitive "cousin" but not usually more virulent. -Mod.LL]. You have to be concerned when you see bacteria mutate into resistant strains before your eyes." [The selection of ESBL producing strains under antimicrobial pressure can be rapid but not in minutes - Mod.LL] Baird said the ESBL infection had definitely "contributed" to the death of an Hairmyres patient.
A spokesman for Lanarkshire Acute hospitals NHS Trust said: "The trust welcomes the report by Dr Baird, which has clearly identified areas for further research that in the long term will bring benefits to patients being treated in hospitals throughout the country. The data gathered on ESBL isolates in Hairmyres Hospital has highlighted the problem faced by hospitals all over the world regarding antibiotic resistant organisms."
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ProMED-mail
<promed@promedmail.org>
[ESBLs are often derivatives of the parent enzymes referred to as TEM and SHV, although lineages from other enzymes (such as OXA and CTX-M) are also found. These enzymes hydrolyze many of the extended-spectrum penicillins and cephalosporins, limiting the therapeutic alternatives of physicians. Enterobacteriaceae, particularly _Klebsiella pneumoniae_, may contain these enzymes. The organism or organisms in the cluster described above are not identified. The observation that a newly opened health care facility in Scotland has developed a cluster of this infection is not a surprise. The antimicrobial pressure for selection of these resistant organisms is not less in newer facilities, and admission or transfer of patients colonized or infected with such bacteria acquired in another hospital is commonplace.
First described in Europe in the early 1980s, ESBL-containing Gram negative bacilli have become a widespread problem (1) especially in western and southern Europe. In one report of ESBL containing intensive care unit isolates from 1996, most were from Belgium, France, Germany, Holland, Italy, Portugal, Spain, and Turkey but some were from the UK (2). Outbreaks, however, have occurred in Ireland (3) and the UK (4).
Control of these isolates involves the same measures as those used for MRSA and vancomycin resistant enterococci control: (1) prudent controlled use of antimicrobials to minimize overutilization and exceeding the required spectrum of therapy; and (2) aggressive infection control to limit patient-to-patient spread. The overuse of extended-spectrum cephalosporins -- rather than that of penicillin/beta-lactamase inhibitor combinations -- seems to be a selection factor for these organisms.
1. Paterson DL. Extended-spectrum beta-lactamases: the European experience. Curr Opin Infect Dis 2001; 14: 697-701.
2. Livermore DM, Yuan M. Antibiotic resistance and production of extended-spectrum beta-lactamases amongst Klebsiella spp. from intensive care units in Europe. J Antimicrob Chemother 1996; 38: 409-24.
3. Grogan J, Murphy H, Butler K. Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a Dublin paediatric hospital. Br J Biomed Sci 1998; 55: 111-7.
4. Shannon K, Stapleton P, Xiang X, et al. Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae strains causing nosocomial outbreaks of infection in the United Kingdom. J Clin Microbial 1998; 36: 3105-10. - Mod.LL]
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Provided under Fair Use for Education doctrine
RR
--------------------------------------------------
From: ProMED-mail <promed@promedmail.org>
Source: BBC [edited]
<http://news.bbc.co.uk/hi/english/uk/scotland/newsid_2009000/2009028.stm>
New "superbug" found in hospital: the ESBL bacterium can break down antibiotics
--------------------------------
A new "superbug" which can neutralize antibiotics and cause fatal blood poisoning [bacteremia -Mod.LL] has been found at a Lanarkshire hospital. The extended-spectrum beta-lactamases (ESBL) superbug is reported to have claimed the life of one patient at Hairmyres in East Kilbride, one of Scotland's most modern hospitals, which opened in 2001.
A study by consultant microbiologist at Hairmyres, Dr Dugald Baird, found that 41 patients contracted the bacteria -- which produce enzymes that break down common antibiotics -- between July 2001 and April 2002. Lanarkshire Acute Hospitals NHS Trust has refused to confirm that a patient had died as a result of the bacteria.
The report, published by the Scottish Centre for Infection and Environmental Health <http://www.show.scot.nhs.uk/scieh/PDF/weekly_report.pdf>, claims it could become the new MRSA (methicillin resistant _Staphylococcus aureus_), a superbug because it is particularly resistant to antibiotics.
Last month, cardiac surgery at Edinburgh Royal Infirmary was halted after it emerged that 13 patients had contracted the superbug [an ESBL or MRSA? - Mod.LL]. Dr Baird said "Initially a lot of the MRSA bacteria were not thought to be very harmful and it may be that we are seeing a similar sort of thing with ESBL producers [The term "superbugs" reflects the antimicrobial resistance pattern and the organism may be about equal to or less pathogenic than its sensitive "cousin" but not usually more virulent. -Mod.LL]. You have to be concerned when you see bacteria mutate into resistant strains before your eyes." [The selection of ESBL producing strains under antimicrobial pressure can be rapid but not in minutes - Mod.LL] Baird said the ESBL infection had definitely "contributed" to the death of an Hairmyres patient.
A spokesman for Lanarkshire Acute hospitals NHS Trust said: "The trust welcomes the report by Dr Baird, which has clearly identified areas for further research that in the long term will bring benefits to patients being treated in hospitals throughout the country. The data gathered on ESBL isolates in Hairmyres Hospital has highlighted the problem faced by hospitals all over the world regarding antibiotic resistant organisms."
--
ProMED-mail
<promed@promedmail.org>
[ESBLs are often derivatives of the parent enzymes referred to as TEM and SHV, although lineages from other enzymes (such as OXA and CTX-M) are also found. These enzymes hydrolyze many of the extended-spectrum penicillins and cephalosporins, limiting the therapeutic alternatives of physicians. Enterobacteriaceae, particularly _Klebsiella pneumoniae_, may contain these enzymes. The organism or organisms in the cluster described above are not identified. The observation that a newly opened health care facility in Scotland has developed a cluster of this infection is not a surprise. The antimicrobial pressure for selection of these resistant organisms is not less in newer facilities, and admission or transfer of patients colonized or infected with such bacteria acquired in another hospital is commonplace.
First described in Europe in the early 1980s, ESBL-containing Gram negative bacilli have become a widespread problem (1) especially in western and southern Europe. In one report of ESBL containing intensive care unit isolates from 1996, most were from Belgium, France, Germany, Holland, Italy, Portugal, Spain, and Turkey but some were from the UK (2). Outbreaks, however, have occurred in Ireland (3) and the UK (4).
Control of these isolates involves the same measures as those used for MRSA and vancomycin resistant enterococci control: (1) prudent controlled use of antimicrobials to minimize overutilization and exceeding the required spectrum of therapy; and (2) aggressive infection control to limit patient-to-patient spread. The overuse of extended-spectrum cephalosporins -- rather than that of penicillin/beta-lactamase inhibitor combinations -- seems to be a selection factor for these organisms.
1. Paterson DL. Extended-spectrum beta-lactamases: the European experience. Curr Opin Infect Dis 2001; 14: 697-701.
2. Livermore DM, Yuan M. Antibiotic resistance and production of extended-spectrum beta-lactamases amongst Klebsiella spp. from intensive care units in Europe. J Antimicrob Chemother 1996; 38: 409-24.
3. Grogan J, Murphy H, Butler K. Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a Dublin paediatric hospital. Br J Biomed Sci 1998; 55: 111-7.
4. Shannon K, Stapleton P, Xiang X, et al. Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae strains causing nosocomial outbreaks of infection in the United Kingdom. J Clin Microbial 1998; 36: 3105-10. - Mod.LL]
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Provided under Fair Use for Education doctrine