Page last updated at 00:00 GMT, Tuesday, 18 November 2008

Drug-resistant ward bug concern

Acinetobacter
Acinetobacter does not usually pose a threat to healthy people

Hospitals need to be vigilant against an emerging drug-resistant bacterium Acinetobacter baumannii, infection control experts have warned.

Like MRSA and Clostridium difficile, the bacterium poses the greatest risk to seriously ill patients.

Rates of resistance to antibiotics that halt the bug currently stand at 30%, Lancet Infectious Diseases reports.

The journal report authors said the infection was a growing public health worry across the world.

Measures in the UK to control MRSA and other "hospital-acquired infections" should also bring down Acinetobacter rates, experts said.

It is important that Trusts remain vigilant in their treatment of this and all healthcare associated infections
A spokeswoman for the Health Protection Agency

Acinetobacter shares many of the "superbug" properties of MRSA and Clostridium difficile, such as survival on surfaces and resistance to disinfectants. This makes it difficult to eradicate from wards once it is there, experts say.

Typically, the bacterium causes bloodstream infections, pneumonia or infection of a wound.

It can be carried on the skin of healthy people and can be passed to patients by poor hand hygiene.

It also survives in dust and on objects such as bedding for months, making rigorous cleaning of wards essential to control its spread.

The strains of Acinetobacter that are resistant to standard treatments can be treated with other antibiotics, however, and the bug does not usually pose a threat to healthy people.

Vigilance

Strict hygiene compliance and more thorough research into drug choice, especially those for multidrug-resistant Acinetobacter baumannii, are vital to prevent major outbreaks, say the report authors Professor Matthew Falagas and Dr Drosos Karageorgopoulos, of the Alfa Institute of Biomedical Sciences in Athens, Greece.

In the UK, the numbers of Acinetobacter bloodstream infections reported to the Health Protection Agency via its voluntary surveillance scheme increased by 5.4% between 2003 and 2007 to 1,187 reports.

We mustn't be complacent but currently its impact can be geographically constrained
Dr Andrew Berrington, a consultant microbiologist at Sunderland Royal Hospital

But the HPA says this increase could be due to increased awareness and reporting rather than a true rise in infection rates.

A spokeswoman for the Health Protection Agency said: "Acinetobacter can cause problems in those who are already seriously ill with weakened immune systems.

"Although we do see some outbreaks of this infection in the UK, numbers of cases are fortunately small.

"Transmission of this infection can be reduced by careful attention to infection control procedures such as cohort nursing groups, hand hygiene and environmental cleaning. It is important that trusts remain vigilant in their treatment of this and all healthcare associated infections."

She said the HPA had no plans to make the reporting of cases mandatory, largely because it is not deemed to be as great a threat as the notifiable hospital-acquired infections such as MRSA and C.difficile.

Professor Richard James, director of the Centre for Healthcare Associated Infections at Nottingham University, said: "If we could overnight solve the problems of hospital infections caused by C.difficile and MRSA then there are other potential superbugs like Acinetobacter baumannii lying in wait.

"Hospitals are full of sick patients and very fit bacteria that will spread from patient to patient unless infection control measures are up to the challenge.

"Acinetobacter baumannii, multidrug resistant tuberculosis (MDR-TB) and extremely drug resistant tuberculosis (XDR-TB) are examples of new threats to public health that are already causing serious problems in other countries."

Dr Andrew Berrington, a consultant microbiologist at Sunderland Royal Hospital, said there was little evidence to suggest outbreaks of Acinetobacter were becoming more common in the UK.

"We mustn't be complacent but currently its impact can be geographically constrained - some hospitals struggle to control outbreaks, others see very little of it."



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