Nationwide investigation into the spread of antibiotic resistant E. coli.

Public Health England has begun a United Kingdom-wide investigation into the spread of antibiotic-resistant E. coli. The study will look at E. coli that produce enzymes known as Extended Spectrum Beta Lactamose (ESBL), which are able to break down common antibiotics like penicillin, and will look at how resistance spreads in patients, healthy people, sewage, slurry and farm animals

Experts say that, about 10 years ago, ESBL-positive E. coli level began to increase. These resistant strains can cause blood poisoning and urinary tract infections. Nowadays some 10% of the 30,000 E. coli infections reported annually are believed to be resistant. The risk in hospitals is growing.

According to Professor Neil Woodford, Head of Antimicrobial Resistance at Public HealthEngland, resistant E. coli from non-human sources pose health threats that are not yet fully understood. He says that, “ The study is very important because its results will help to shape future intervention strategies to reduce the spread of these antibiotic-resistant strains of bacteria and to reduce the numbers of infections that they cause.”

One of the problems is that, although other classes of antibiotics can be used to treat infections, doctors do not know what strain is affecting the patient. This means that it is possible to give inappropriate drugs that may be ineffective and could lead to fatal consequences.

Dr DavidWareham, a consultant microbiologist at Queen Mary, University of London, illustrates the point. He says that growing the bacterium takes several days with a further day required for a resistance test. This means that doctors can be forced to use broad-spectrum antibiotics, exacerbating the problem and driving resistance.

According to Peter Hawkey, Professor of Public Health and Clinical Bacteriology at the University of Birmingham, overseas travel is a major risk factor in the spread of resistant strains of E. coli. In India, for example, ESBLs comprise 60% of all E. coli infections – against 10% currently in the United Kingdom - and 85% of visitors are likely to pick up resistant organisms, even though symptoms may not present. A figure of 60% in Britain would lead to increased use of last-resort antibiotics.