Studies show drug-resistant bug threats in Europe

LONDON (Reuters) - Drug-resistant infections with the “superbug” Clostridium difficile are rising in Europe and are widespread, scientists said on Tuesday, but there are big variations in the way health authorities monitor them.

In a Europe-wide study, researchers found the incidence of C-difficile infections in hospitals had risen to 4.1 per 10,000 patient days in 2008 from 2.45 per 10,000 patient days in 2005.

“It is clearly on the increase, that’s for sure,” said Ed Kuijper of Leiden University Medical Center in The Netherlands, who led the study with his colleague Martijn Bauer.

“There is also a huge variation of incidence in different European countries -- mainly due to the fact that each country uses its own surveillance system and its own diagnostic tests, so in some countries it is underestimated and in other countries it is overestimated.”

Overuse and misuse of antibiotics in recent decades have fueled a rise in drug-resistant “superbug” infections like C-difficile, a bacterial infection in the gut, and methicillin-resistant Staphyloccus aureus (MRSA).

Earlier this year, scientists warned that a new so-called superbug from India known as New Delhi metallo-beta-lactamase (NDM-1) could spread around the world.

The European Center for Disease Prevention and Control (ECDC) said that up to 400,000 patients in the region suffer multi-drug resistant infections and antibiotic resistance remains a major public health problem.


Launching a campaign to increase awareness of antibiotic overuse, the ECDC highlighted a particular bug called Klebsiella pneumoniae, a common cause of infection amongst hospital patients, which like NDM-1 is becoming increasingly resistant to powerful last-line antibiotics such as carbapenems.

“Antibiotic resistance remains a serious threat to patient safety, reducing options for treatment and increasing lengths of hospital stay, as well as patient morbidity and mortality,” said ECDC director Marc Sprenger.

Kuijper’s study, which was published in The Lancet medical journal found C-difficile infection rates were high in countries such as Finland, Poland and Britain, which had rates of 19.1, 12.5 and 10.4 per 10,000 patient days respectively, and lower in places such as France and Hungary, which had incidences of 2.1 and 2.0 per 10,000 patient days.

When the researchers followed the patients up after three months, they found that 22 percent had died, and C-difficile infection had played a part in 40 percent of those deaths.

“This is the most important hospital-acquired infection in Europe, because if you look at the outcomes, there is a high mortality rate,” Kuijper said in a telephone interview.

“There should be European-wide guidelines for hospitals to monitor this disease more carefully using uniform standards.”

Commenting on the findings, experts from the United States said good surveillance was vital to fight drug-resistant bugs.

“To stay ahead of these costly and deadly outbreaks, we need to know what is out there,” wrote Cirle Warren and Richard Guerrant of the University of Virginia. “One thing is certain: antibiotic-resistant C-difficile is here to stay, as long as antibiotics are around.”

Editing by Janet Lawrence