Rx-Resistant E. Coli: An Emerging Threat

Antibiotic-resistant E. coli infections on the rise in community hospitals

(RxWiki News) Antibiotic-resistant "superbugs" are here — and new evidence suggests that their numbers are rising.

A new study from Duke University School of Medicine found that the number of antibiotic-resistant E. coli infections seen in small, community hospitals has doubled in recent years. This finding may be cause for concern considering that more than half of all US patients are treated in these facilities, according to researchers.

"We have always considered antibiotic-resistant organisms a problem at large hospitals," said senior study author Deverick Anderson, MD, an infectious disease specialist at Duke, in a press release. "This study goes a long way in demonstrating that the problems with antibiotic-resistant organisms occur in all health care settings, not just large ones. This is also one of the first papers to show these infections are increasing outside of the health care system in the community."

Escherichia coli (E. coli) bacteria normally live in the intestines of healthy people and animals, but a few particularly nasty strains can cause severe abdominal cramps, diarrhea and vomiting. Healthy adults typically recover from E. coli infection within a week, but young children and older adults have a risk of developing life-threatening complications if infected.

The most common way E. coli is spread is through contaminated food and water. However, E. coli bacteria can also travel from person to person, especially when infected adults and children don't wash their hands properly.

For this study, Dr. Anderson and team looked at patient records from 26 hospitals between 2009 and 2014.

The incidence of drug-resistant E. coli bacteria doubled during this time from 5.28 incidents per 100,000 patients in 2009 to 10.5 infections per 100,000 patients in 2014. The average age of the infected patients was 72.

According to Dr. Anderson and team, because the majority of E. coli infections occur after health care exposure, all hospitals (both big and small) should be considered important areas of transmission.

However, these researchers also found a three-fold increase in antibiotic-resistant infections among community members who had limited exposure to health care settings. And these patients were found to acquire the "superbug" at an even faster rate than patients who had regular contact with hospitals.

Lead study author Joshua Thaden, MD, a research fellow in Duke's Division of Infectious Diseases, said that it may be time to actively screen patients for antibiotic-resistant E. coli.

"It’s important to consider that a patient’s skin may be colonized with drug-resistant bacteria, but because they do not display symptoms, providers may not test them or use extensive contact precautions during care," Dr. Thaden said in a press release. "I think we may be close to a point where it becomes worth the cost and effort to actively screen patients for resistant E. coli."

According to the Centers for Disease Control and Prevention (CDC), while antibiotics and similar drugs have greatly reduced illness and death from infectious diseases, these drugs have been used so widely and for so long that the organisms they are designed to kill have adapted, making some of the drugs less effective. Each year in the US, more than 2 million people become infected with antibiotic-resistant bacteria.

This study was published Oct. 13 in the journal Infection Control & Hospital Epidemiology

The National Institutes of Health and the CDC funded this research. No conflicts of interest were disclosed.

Review Date: 
October 14, 2015