Rising incidence of antibiotic resistance increases risk of a pandemic

Drastic intervention is required when faced with a nationwide outbreak of highly resistant bacteria

 

Latest figures from the European Centre for Disease Prevention and Control (ECDC) show that, in 2015, antibiotic resistance continued to increase for most bacteria. In particular, the figures highlight growing resistance to antibiotics that represent the last treatment option for patients infected with certain bugs.

These bacteria pose a significant threat to patient safety: poor patient outcomes; higher morbidity and mortality; and higher costs and length of hospital stay are associated with infections caused by highly resistant bacteria. Increased mortality rates, ranging from 26 per cent to 44 per cent are directly associated with having an infection with these microbes.

Of particular concern is the rise in the number of cases of Klebsiella pneumoniae – a common cause of urinary tract and respiratory infections – resistant to both the carbapenem and polymyxin groups of antibiotics. The loss of these so-called last-line antibiotics means there is no viable treatment for patients infected with the resistant version of the bug.

In the Republic, figures from the Health Protection Surveillance Centre show a slight rise in the use of the last line antibiotic, carbapenem, in 2015. And Ireland was among the countries that saw an increase in the use of antibiotics in the hospital sector over the same period.

A decrease in methicillin-resistant Staphylococcus aureus (MRSA) cases across Europe between 2012 and 2015 shows remedial action can be effective. But sometimes drastic intervention is required: faced with a nationwide outbreak of highly resistant bacteria, Israel introduced the mandatory isolation of all hospitalised carriers of resistant microbes; it also set up a task force with statutory authority to collect data directly from hospitals and to intervene to control outbreaks. This produced a five-fold reduction in the incidence of highly resistant bacteria within a year.

With recent major outbreaks of antibiotic resistance at Tallaght and University of Limerick hospitals, the potential for a nationwide pandemic exists. Commitment at the highest political level is needed to ensure this does not happen.

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