News | Antimicrobial Resistance
The Growing Threat of Antimicrobial Resistance In Hospitals: How Evolving Bacteria Are Creating A Global Crisis
Time to read: 03:36
Time to listen: 05:58
Published on MedED: 26 November 2024
Type of article: News
MedED Catalogue Reference: MNG0064
Category: News
Category Cross-reference: Public Health, AMR, Genetics
Keywords: antimicrobial resistance, genetics, AMR
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Type of article: News
MedED Catalogue Reference: MNG0064
Category: News
Category Cross-reference: Public Health, AMR, Genetics
Keywords: antimicrobial resistance, genetics, AMR
Top
18 November 2024, 12:15
Linda Ravenhill
Antimicrobial resistance (AMR) is a pressing global health challenge, and its development is closely linked to the genetic mechanisms that allow bacteria to adapt to and survive the drugs designed to kill them.
One of the most concerning processes in AMR is Horizontal Gene Transfer (HGT), through which bacteria share genetic material, including resistance genes, with one another. This allows resistance to spread rapidly across different bacterial species, compounding the difficulty of managing infections.
HGT occurs through three primary mechanisms: transformation, transduction, and conjugation. Transformation involves bacteria absorbing free-floating DNA from their environment, often from the remains of dead bacteria. Transduction occurs when bacteriophages (viruses that infect bacteria) transfer resistance genes between bacteria.
However, conjugation is particularly troubling as it enables bacteria to exchange genetic material directly through physical contact. During conjugation, bacteria transfer entire resistance plasmids—pieces of DNA that carry multiple resistance genes—allowing the rapid spread of resistance traits among different bacteria, often across different species.
This process is especially alarming in healthcare settings. Bacteria that acquire resistance genes can become resistant to multiple antibiotics, complicating treatment options and putting patients at greater risk of infections that are harder to treat. In low—and middle-income countries, the spread of such resistant bacteria is exacerbated by under-resourced hospitals and poor infection control practices.
A recent study led by researchers at the Ineos Oxford Institute for Antimicrobial Research highlighted the dangers of AMR in hospital environments, particularly in intensive care units for newborns.
The study investigated the presence of antibiotic-resistant bacteria on surfaces in 10 hospitals in six low—and middle-income countries: Bangladesh, Ethiopia, Nigeria, Pakistan, Rwanda, and South Africa. The hospitals were selected for their vulnerability to AMR, and the surfaces sampled included those near sink drains, furniture, medical equipment, and emergency neonatal care areas.
Over 6,000 surface swabs were collected from hospitals in these countries, and a significant number were colonized by bacteria carrying resistance to carbapenems, the last-line antibiotics used to treat severe infections like newborn sepsis.
The study revealed that resistance genes were particularly prevalent in areas surrounding sink drains, a key hotspot for bacterial growth. These findings are troubling, as they suggest that AMR could spread rapidly within hospital settings, putting newborns—especially those in neonatal intensive care units—at serious risk of acquiring resistant infections.
Among the bacterial species identified were Klebsiella pneumoniae, Enterobacter hormaechei, Acinetobacter baumannii, Serratia marcescens and Leclercia adecarboxylata were dominant.
One particularly concerning finding was that the same pathogens were detected multiple times in a single ward, indicating clonal persistence within the environment. Additionally, these pathogens were found to be identical to those isolates responsible for causing neonatal sepsis in Pakistan during similar time frames.
The study also identified a worrying trend: resistance genes were often found on mobile genetic elements, which are easily transferred between bacteria. This mobility allows resistance to spread quickly, both within the same surface and across different surfaces, further increasing the potential for infection spread. In hospitals with insufficient infection control measures, the rapid transfer of resistance genes poses a significant risk to patients, limiting their treatment options and increasing the burden on healthcare systems.
The findings underscore the urgent need for improved infection prevention and control strategies, particularly in resource-limited hospitals. Steps such as ensuring access to safe drinking water, improving hospital infrastructure, and implementing tailored infection control programs, including the regular cleaning and disinfecting of surfaces, could help reduce the spread of AMR.
However, many hospitals in low- and middle-income countries lack the financial resources needed to implement these measures. As a result, global investment in infection prevention and control is crucial to prevent further deaths from AMR-related infections, particularly in vulnerable populations like newborns.
With AMR already costing the global economy billions of dollars each year, addressing the spread of resistant bacteria is not only a health imperative but an economic necessity. Ensuring that hospitals, especially in low-resource settings, can better control the spread of resistant bacteria is vital in the fight against one of the most serious public health threats of our time.
This story was compiled from various resources including:
Original research
Nieto-Rosado, M., Sands, K., Portal, E.A.R. et al. Colonisation of hospital surfaces from low- and middle-income countries by extended spectrum β-lactamase- and carbapenemase-producing bacteria. Nat Commun 15, 2758 (2024). https://doi.org/10.1038/s41467-024-46684-z
News story
20 November 2024 | The Conversation| We studied drug-resistant bacteria on hospital surfaces in six countries. This is what we found
Nieto-Rosado, M., Sands, K., Portal, E.A.R. et al. Colonisation of hospital surfaces from low- and middle-income countries by extended spectrum β-lactamase- and carbapenemase-producing bacteria. Nat Commun 15, 2758 (2024). https://doi.org/10.1038/s41467-024-46684-z
News story
20 November 2024 | The Conversation| We studied drug-resistant bacteria on hospital surfaces in six countries. This is what we found
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