Healthy Discoveries: Studies show drug-resistant bug threats in Europe

Healthy discoveries

Drug-resistant infections with the "superbug" Clostridium difficile are Increasing in Europe and are widespread, scientists said on Tuesday, 16 November 2010, but there are big variations in the way health authorities monitor them.

Researchers found in a Europe-wide study that the incidence of C-difficile infections in hospitals had risen to 4.1 per 10,000 patient days in 2008 from 2.45 per 10,000 patient days in 2005.


"It is plainly on the increase, that's for sure," said Ed Kuijper of Leiden University Medical Centre in The Netherlands, who led the study with his colleague Martijn Bauer.


"There is also a great alteration of incidence in different European countries -- mainly because of the fact that each country uses its own surveillance system and its own diagnosis tests, so in some countries it is underestimated and in other countries it is overestimated."


In recent decades, Overuse and misuse of antibiotics have fuelled a rise in drug-resistant "superbug" infections like C-difficile, methicillin-resistant Staphyloccus aureus (MRSA) and a bacterial infection in the gut.


Earlier this year, scientists cautioned that a new so-called superbug from India known as New Delhi metallo-beta-lactamase (NDM-1) could spread around the world.


The European Centre for Disease Prevention and Control (ECDC) said that up to 400,000 patients in the region suffer multi-drug resistant infections and antibiotic resistance remains a main public health troubles.


"Serious threat"


Launching a campaign to augment awareness of antibiotic overuse, the ECDC highlighted a particular bug called Klebsiella pneumoniae, a common reason of infection amongst hospital patients, which like NDM-1 is becoming increasingly resistant to strong last-line antibiotics like carbapenems.


"Antibiotic resistance remains a serious threat to patient safety, decreasing options for handling and increasing lengths of hospital stay, as well as patient morbidity and mortality," said ECDC director Marc Sprenger.


Kuijper's study, which was published in The Lancet medical journal found that C-difficile contagion rates were high in countries like Finland, Britain and Poland, which had rates of 19.1, 12.5 and 10.4 per 10,000 patient days respectively, and lower in places like Hungary and France, which had incidences of 2.1 and 2.0 per 10,000 patient days.


When the researchers pursued the patients after three months, they found that 22% had died, and C-difficile infection had played a part in 40% of those deaths.


"This is the most important hospital-acquired infection in Europe, because if you look at the results, there is a high mortality rate," Kuijper said in a telephone interview.


"There should be European-wide guidelines for hospitals to oversee this disease more carefully using uniform standards."


Commenting on the results, Experts from the United States said that good supervision was vital to fight drug-resistant bugs.


"To stay ahead of these costly and deadly outbreaks, we need to know what is out there," wrote Cirle Warren and Richard Guerrant of the University of Virginia. "One thing is assured: antibiotic-resistant C-difficile is here to stay, as long as antibiotics are around."

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