The Reporter
Issue no 487, 27 January 2003
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Winning the war against the superbugs

 

In the race to between antibiotics advanced and bacteria that cause infections, the bugs appear to be taking the lead. Stories of new resistant strains are constantly hitting the headlines. Hospitals are the battleground, with patients with weakened defences against disease particularly at risk. The University is fighting the battle on two fronts, looking at how resistance develops and spreads, and finding new ways to fight infections threatening the most vulnerable hospital patients.

Infection control is of crucial importance in hospitals. Wards have to be scrupulously clean and strict procedures followed when dealing with patients, to reduce transmission by contact. But not all infections are caught through touch, and researchers at Leeds have been looking at how to clean up the very air patients breathe.

negative air ioniserA team from civil engineering has been studying the effect of negative air ionisers on infections caused by acinetobacter, a pathogen responsible for increasing numbers of sometimes fatal infections amongst hospital patients. Many strains of acinetobacter are resistant to antibiotics, and it is becoming increasingly difficult to treat.

Cleaning the air – the ioniser at work at St JamesŐs

Ionisers were placed in the intensive care unit at St James’s University Hospital, which, like similar wards across the UK, has had recurrent problems with acinetobacter infections. Bacteria levels and patient infections in the unit were monitored for the first six months, without the ionisers in use. Then the ionisers were switched on, and the results were impressive: infections due to acinetobacter reduced dramatically. (Full figures will be published in academic papers over the next few months.)

Dr Clive BeggsLead researcher Dr Clive Beggs said: “We believe that the negative air ions actually remove the bacteria from the air, so stopping the transmission of infection. Our tests focused solely on acinetobacter, but it’s possible the ionisers may have an effect on other airborne bacteria.”

Fighting infections – Clive Beggs

Further trials and experiments are already under way, but lead consultant at St James’s intensive care unit, Stephen Dean, is already satisfied that the ionisers make a difference. “We wanted to be involved in the trial as infections are a major issue for units such as ours, where many patients are already very vulnerable,” he said. “The results have been fantastic – so much so that we asked the University to leave the ionisers with us. Since the trial finished, we’ve kept them in operation, and are still seeing greatly reduced acinetobacter infections on the ward.”

Since April 2001, all NHS trusts involved in acute and specialist care have been required to collect and nationally report data on the most infamous so-called ‘superbug’, MRSA, but national figures on other resistant bacteria are not available. In June 2000, the National Audit Office estimated there were 100,000 cases of hospital-acquired infections each year, costing the taxpayer around £1,000m.

Dr John HeritageEven if we radically change the way we use antibiotics, the problem is unlikely to go away, according to Dr John Heritage, from biochemistry and molecular biology. He has been monitoring resistant bacteria for many years, and has found that resistance can persist, even once an antibiotic is no longer in use. He was contacted by the Eastern Virginia Medical School following ground-breaking work carried out at St James's. Over half the children in the US hospital have resistant bugs in their system, and on the worst ward, 60% of patients are in isolation. He is helping staff there find out how the resistant bacteria are spreading.

Hunting jumping genes – John Heritage

Blood tests on leukaemia patients at St James’s identified six bacteria with a gene which conferred antibiotic resistance. Further tests on gut bacteria from the same patients then found over 80 strains of resistant bacteria, showing those in the blood were just the tip of the iceberg.

“Resistance can either spread through patient to patient contact, or between different bacteria”, said Dr Heritage. “The DNA which confers resistance is sometimes found on a ‘jumping gene’ – a gene able to move from one bacterium to another, leaving a ‘copy’ of itself behind.”

The St James’s ward stopped using the antibiotic in question in 1989, but Dr Heritage continued to monitor patients, and found resistance persisted for over ten years.

Over 90% of cells in the human body are bacteria, and most of these don’t cause us any problems. “The problems arise when malign bacteria become resistant to antibiotics, making infections difficult to treat,” said Dr Heritage. “Use of an antibiotic to fight infection itself helps increase the numbers of bacteria resistant to that antibiotic, by killing bacteria which aren’t resistant, leaving the field clear for other, resistant bacteria to proliferate.”

See press release for more details.

 
 


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