Multi-resistant bacteria can be prevented
(Vienna, 18 August 2010) Bacteria which are resistant to antibiotics represent a problem for the treatment of diseases. To prevent or curb the occurrence of these bacteria before a possible disease, doctors need to act responsibly when using wide-spectrum antibiotics. Excessive doses could lead to resistance, as is currently the case with the "NDM-1 bacteria". Adhering to hygiene regulations in hospitals is also a necessary requirement to prevent spread.
It is mainly common intestinal bacteria which become resistant to conventional antibiotics. Humans with an intact immune system can carry such bacteria inside them for their whole lives without ever becoming ill as a result. Only when antibiotics are used are weaker bacteria killed but the remaining ones become stronger and can then multiply better. With gene mutation they are also capable of entirely cancelling out the mode of action of antibiotics at a later point, for example with the development of the NDM-1 gene. In case of infection by such bacteria the common drugs are therefore ineffective and special antibiotics are either not available or they have serious side effects.
"The occurrence of enterobacteria carrying NDM-1 is the result of the excessive use of penems, the currently most potent and in hospitals most frequently used groups of antibiotics. Experts have always warned against using penems for initial therapy because with the development of resistance the following motto applies: the more you use it, the earlier you lose it. The ill-considered use of penems in beauty clinics in Pakistan has now led to the formation of the New Delhi metalloproteinase in enterobacteria and patients have brought these pathogenic agents to Europe. Bacteria which form this enzyme are resistant to all of these antibiotics," explains the Head of the Division of Infectious Diseases and Tropical Medicine at MedUni Vienna, Univ. Prof. DDr. Wolfgang Graninger.
"The spread can be stopped only with hygiene measures and by not using penems for routine treatment. To prevent spreading there has to be a hygienic environment above all in the hospitals. With the high density of bacteria arising naturally from the many patients, the risk of infection also rises accordingly. Here only adherence to strict hygiene regulations can help take the breeding ground away from the bacteria and therefore contain them to stop them spreading at least. Patients from India and Pakistan should also be isolated from the start. Reserve antibiotics like tigecycline should also be used only after consultation with infection specialists.
Multi-resistant pathogens can be prevented only by clever use of antibiotics. In the AKH University Hospital corresponding steps were taken several years ago, but in terms of the use of penems these need to be intensified, however," Graninger says in conclusion.