Sludge Watch ==> Fatal form of drug resistant Ecoli (ESBL)

[Maureen Reilly]

http://www.timesonline.co.uk/tol/news/uk/health/article2511957.ece

The Sunday TimesSeptember 23, 2007

Threat from ‘new E-coli’

Sarah-Kate Templeton, Health Editor

A new superbug that scientists believe is brought into Britain through the 
food chain is infecting about 30,000 people a year, according to government 
experts.

Research has found that between 10% and 14% of those who are infected with 
the drug-resistant form of E-coli die within 30 days of catching the bug, 
which would suggest 3,000-4,200 deaths. This would be double the number of 
deaths from MRSA.

Unlike traditional forms of E-coli, the drug-resistant strain 
Extended-Spectrum Beta-Lacta-mase (ESBL) affects healthy young adults as 
well as the elderly. Doctors say the Health Protection Agency (HPA), the 
government body responsible for protecting the public from infections, has 
failed to recognise the scale of the problem and needs to do more to control 
the spread of the bacteria.

Dr Graham Harvey, consultant microbiologist at Shrewsbury & Telford 
Hospitals NHS Trust, said: “We need to be concerned about this. It is a 
significant cause of mortality. It is something that has been missed 
nationally, and by the HPA in particular. Some form of surveillance needs to 
be put in place.”

Dr Albert Lessing, director of infectious diseases at Heather-wood and 
Wexham Park Hospitals NHS Trust in Berkshire, said that two years ago he was 
treating hardly any cases. Now he sees six cases of E-coli ESBL a day.

“In the past month we have seen two men in their fifties with the organism 
in their blood. Previously, E-coli in the blood of a 50-year-old man was 
unheard of. We have also seen infections in a couple of women in their late 
thirties or early forties. This is a new phenomenon which is poorly 
understood,” Lessing said.

The bacterium causes urinary infections but can also lead to blood 
poisoning. Hospitals can report E-coli ESBL blood infections to the HPA on a 
voluntary basis, but there is no system to report the more common urinary 
infections. In the absence of a national surveillance system, concerned 
doctors at individual hospitals have set up their own recording systems.

Last week Harvey and colleagues, including Professor Peter Hawkey of the HPA 
West Midlands Public Health Laboratory, presented their research at an 
international microbiology conference in Chicago, which showed that 14% of 
people who become infected with E-coli ESBL die within 30 days. HPA 
scientists estimate there are about 30,000 cases of infection due to ESBL 
every year in Britain. The scale of the problem will feature in an 
investigation by Tonight with Trevor McDonald that will be broadcast 
tomorrow on ITV1.

Professor Peter Collignon, director of the infectious diseases unit and 
microbiology department at Canberra hospital, Aus-tralia, believed the 
widespread use of antibiotics in cattle, pigs and chicken had caused drug 
resistant strains of E-coli to develop in meat and poultry. E-coli ESBL is 
believed to be brought into Britain through imported chicken, although the 
link has not been proven.

Doctors try to hold back so-called critically important antibiotics to treat 
patients with serious diseases for which there are few alternatives. But 
Collignon, who advises the World Health Organisation on the international 
spread of E-coli ESBL, said these drugs are being used in the food chain in 
many parts of the world.

“We restrict the use of antibiotics in most people because we know that when 
we use any antibiotic, resistance develops. We hold back an important group 
of antibiotics, called third and fourth generation cepha-losporins, for the 
sickest people. I find it perverse that we are using these types of drugs in 
food animals,” Collignon said.