Superbug Warning: New Report Warns MRSA Is Reaching Epidemic Levels In European Hospitals

Main Category: MRSA / Drug Resistance
Also Included In: Immune System / Vaccines
Article Date: 15 Dec 2006 - 10:00 PDT

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Data published in the European Antimicrobial Resistance Surveillance System (EARSS) 2005 Annual Report, highlights that for the sixth year running, MRSA prevalence is rising consistently across Europe, with the UK being the fifth worst affected in Europe after Malta, Cyprus, Romania and Portugal. The report states, however, that two countries - Slovenia and France have managed to decrease infection rates through implementing the appropriate long term control efforts - yet the UK has not reversed the trend over the last 6 years. The overall increase in MRSA, is largely symptomatic of rising antimicrobial resistance (AMR)(1) - the increasing number of resistant pathogens across the UK & Europe. The report warns that AMR is seriously threatening the successful and effective treatment of infections - resulting in an ever increasing death toll and disease burden(1).

Antibiotic treatments are widely used to treat hospital acquired infections (HAI) - of which there have been three million per year in the extended EU, resulting in an alarming 50,000 deaths to date.(2)

Mark Wilcox, clinical Director of Microbiology & Infection Control, Leads Teaching Hospital explains:

"The findings of the EARSS report are worrying and clearly illustrate that antibiotic resistance is continuing to increase markedly. If this trend continues and is not tackled effectively, it is likely that more patients will die because of infections caused by multi-drug resistant bacteria. The financial effects of increased hospital stays and subsequent treatment will continue to drain European healthcare systems. Appropriate management and treatment regimens need to be implemented and audited for their effectiveness."

Inappropriate use of antibiotics continues to be a major contributory factor to the increasing number of resistant pathogens across Europe. Many of these causative organisms, such as MRSA, have developed resistance to multiple antibiotics.(3) Hospital patients, as a result of their sometimes weakened immune systems, are particularly vulnerable to these resistant strains,(4) developing infections that can manifest as infected burns, deep abscesses, surgical wound infections, perforations, or complicated appendicitis, among others. When these clinical complications are added to patients' existing medical conditions they can prove fatal or lead to longer stays in hospital, and therefore a greater burden on health care systems.(5)

While antimicrobial resistance is increasing in the main across Europe, EARSS data reveals that specific resistance trends can be affected by local environments including incidence and strains of pathogens, local antibiotic prescribing habits and hospitals.

Due to rising antimicrobial resistance, it is important to initiate empiric treatment of complicated and serious infections quickly with broad-spectrum antibiotics, as currently available antimicrobial testing methods may take at least 48 hours to identify the bacteria causing the infection.

Tigecycline is one of a limited number of new broad-spectrum antibiotics available in Europe which can be used when the causative bacteria are still unknown.(6)

Mark Wilcox comments:

"Increasing antimicrobial resistance is a complicating factor in the treatment of infections - particularly in the hospital setting. When a patient develops a serious infection in hospital it usually takes between 24 and 48 hours to identify the bacteria responsible. In these critical early stages of treatment, it is important to have efficacious broad-spectrum antibiotics available. Tigecycline is a useful new alternative broad spectrum antibiotic option that provides cover against the types of multi-drug resistant bacteria that are increasingly common in Europe."

Tigecycline was developed by Wyeth to overcome two key tetracycline resistance mechanisms, efflux pumps and ribosomal protection, and is unaffected by other bacterial mechanisms of resistance such as extended spectrum beta-lactamases (ESBLs), which have limited the number of antibiotic options available.

Dr David McIntosh, Medical Director, Infectious Diseases, Wyeth Pharmaceuticals comments, "tigecycline provides clinicians with an important alternative in the treatment of complicated skin and soft tissue infections, and complicated intra-abdominal infections." He continues, "Since July 2006 tigecycline has been used in patient care in many hospitals in the United Kingdom, and it is hoped that with its increased availability in Europe, many more patients will now be able to benefit from this new effective antibiotic."

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Notes:

About Tigecycline

Tigecycline was developed by Wyeth to overcome the two key tetracycline resistance mechanisms, efflux pumps and ribosomal protection, and is unaffected by other bacterial mechanisms of resistance such as extended spectrum beta-lactamases (ESBLs), which have limited the number of antibiotic options available.

Tigecycline is active against many gram-positive bacteria, such as MRSA, and common gram-negative pathogens, such as Escherichia coli. It can be used as an empiric monotherapy (before the causative bacteria are identified) in the treatment of skin or intra-abdominal infections, especially those that may be caused by a mixture of different bacteria acquired either in the hospital or in the community. The most common adverse events reported in clinical trials with Tigecycline were transient nausea (20%) and vomiting (14%). These occurred early and were generally mild or moderate in severity. Tigecycline is supported by comprehensive global in vitro studies and an in vivo clinical trials programme and was available to selected patients prior to approval as part of a compassionate use programme.

It is currently available in Austria, Germany, France, Portugal, Italy, Greece, Denmark, Sweden, Finland, the Czech. Republic and the UK. Tigecycline received FDA approval in June 2005 and has since received regulatory approval in Brazil, Colombia, Argentina, Mexico, Peru, Ecuador, Kuwait, Qatar, and the Philippines.

About Wyeth

Wyeth is one of the world's largest research-driven pharmaceutical and health care products companies. It is a leader in the discovery, development, manufacturing and marketing of pharmaceuticals, vaccines, biotechnology products and non-prescription medicines that improve the quality of life for people worldwide. The Company's major divisions include Wyeth Pharmaceuticals, Wyeth Consumer Healthcare and Fort Dodge Animal Health.

Wyeth Pharmaceuticals

Wyeth Pharmaceuticals, a division of Wyeth, has leading products in the areas of women's health care, cardiovascular disease, central nervous system, inflammation, transplantation, hemophilia, oncology, vaccines and nutritional products. Wyeth is one of the world's largest research-driven pharmaceutical and health care products companies. It is a leader in the discovery, development, manufacturing and marketing of pharmaceuticals, vaccines, biotechnology products and non-prescription medicines that improve the quality of life for people worldwide. The Company's major divisions include Wyeth Pharmaceuticals, Wyeth Consumer Healthcare and Fort Dodge Animal Health.

About EARSS

The European Antimicrobial Resistance Surveillance System (EARSS), funded by Health and Consumer Protection, Directorate G of the European Commission and coordinated by the Dutch National Institute for Public Health and the Environment (RIVM), is an international network of national surveillance systems, which collects comparable and validated antimicrobial susceptibility data for public health purposes. Since 2004, surveillance of antimicrobial susceptibility has been monitored in Klebsiella pneumoniae, Pseudomonas auruginosa, Streptococcus pneumoniae, Staphylococcus aureus, Escherichia coli, and Enterococcus faecalis/faecium causing invasive infections and monitors variations of antimicrobial resistance over time and place.

References

1) European Antimicrobial Resistance Surveillance System (EARSS) 2005 Annual Report. Available here.

2) Hospitals in Europe Link for Infection Control Through Surveillance (HELICS). About HELICS. Available here. Accessed February 20, 2006.

3) Goosens H, Ferech M, Stichele RV, et al, for the ESAC Project Group. Outpatient antibiotic use in Europe and association with resistance; a cross-national database study. Lancet. 2005; 365: 579-587.

4) Shlaes DM, Gerding DN, John JF Jr, et al. Society for Healthcare Epidemiology of America and Infectious Diseases Society of America Joint Committee on the Prevention of Antimicrobial Resistance: Guidelines for the Prevention of Antimicrobial Resistance in Hospitals. Clin Infec Dis. 1997; 25: 584-599.

5) Cosgrove SE, Carmeli Y. The impact of antimicrobial resistance on health and economic outcomes. Clin Infect Dis. 2003; 36: 1433-1437.

6) Wyeth Europa interpretation of the EMEA-approved Summary of Product Characteristics.

For further information please visit:
European Antimicrobial Resistance Surveillance System
Wyeth Pharmaceuticals

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