Infection control nurses have been warned about a little-known bacterial enzyme that causes resistance to antibiotics.
Speaking at the Infection Prevention 2010 conference in Bournemouth last week, Hilary Humphreys, professor of clinical microbiology at the Royal College of Surgeons in Ireland, warned that extended-spectrum ß-lactamases (ESBLs) were a “problem [that] is already with us, and more difficult to prevent or contain than MRSA or C difficile”.
Introducing Nursing Times Learning
Subscribers get fiveFREE learningunits and non-subscribers can access each learning unit for £10 + VAT.
ESBLs are the result of a genetic mutation to common Gram negative bacteria such as Escherichia coli and Klebsiella pneumoniae. These bacteria are normally treatable with antibiotics. However, once they can produce ESBLs, they become resistant.
Professor Humphreys said the overuse of antibiotics had “facilitated ESBLs’ survival and subsequent dissemination” but that, according to a study last year, only half of intensive care units had a policy on antibiotic use.
Patients with serious underlying diseases - particularly diabetes - are most at risk.
Professor Humphreys said: “How do we solve the problem? With difficulty, to be honest.”
He said laboratory detection was slow and difficult. In addition, unlike with MRSA, new agents were unlikely to be developed to combat it.
The professor, a consultant microbiologist at the Beaumont Hospital in Dublin, said that, given the possibility of ESBLs being picked up outside the hospital, “effective prevention might be outside the control of the healthcare community”.
He presented the results of a screening study that found 40 per cent of 294 nursing home residents at 16 sites in Belfast tested positive for ESBL.
There was no consensus on screening for ESBLs, he added.