It is possible that hospital types of antibiotic resistant Escherichia coli (E. coli) bacteria may soon infect patients in community settings. This would be a situation similar to that of community-acquired meticillin-resistant Staphylococcus aureus (MRSA), according to a Review published in March in The Lancet Infectious Diseases.

Often, these E. coli infections manifest themselves as urinary tract infections. Recent reports have also described antibiotic resistant E. coli strains in bloodstream infections. The authors of the report, Dr Johann Pitout, Calgary Laboratory Services, Calgary, and University of Calgary, Alberta, Canada and Dr Kevin Laupland, University of Calgary, Alberta, Canada, state that the antibiotic resistant E. coli bacteria that cause these infections should be identified soon to prevent their transmission and help select more effective antibiotics.

This Review focused on types of E. coli that produce β-lactamases — these enzymes help give E. coli their antibiotic resistance. Notably, many surveys since 2000 from various European countries (including UK, Spain, Italy, Greece, and Canada) have shown a trend of resistance to various antibiotics in E. coli. According to the authors, “Infection control practitioners and clinicians need the clinical laboratory to rapidly identify and characterize different types of resistant bacteria efficiently to minimize the spread of these bacteria and help select more appropriate antibiotics…these bacteria have become widely prevalent in the community setting in certain areas of the world and they are most likely being imported into the hospital setting.”

They recommend that funding be directed internationally to follow and monitor the propagation of these resistant E. coli in hospital and community settings. Their conclusion is that the risk of bloodstream infections in the community caused by this bacteria, while currently low, may in the future become a regular clinical problem, especially in the β-lactamase producing E. coli. These infections are currently rare, but it is possible that, in the near future, clinicians will be regularly confronted with hospital types of bacteria causing infections in patients from the community, a scenario very similar to that of community-acquired MRSA.”

Extended-spectrum β-lactamase-producing Enterobacteriaceae: an emerging public-health concern
Johann D D Pitout, Kevin B Laupland
The Lancet Infectious Diseases 2008; 8:159-166
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Written By Anna Sophia McKenney