Carbapenems are heavy-hitting antibiotics often reserved as the last line treatment for illnesses like hospital-acquired pneumonias, urine infections or blood poisoning caused by strains of Klebsiella and E. coli bacteria that are resistant to other antibiotics.Several strains of these bugs are now also becoming resistant to carbapenems, something experts say puts modern medicine under threat.“It is critical ... to understand how much of modern medicine — from gut surgery to transplants — depends on the ability to treat infection,” said David Livermore, director of antibiotic resistance monitoring at the Health Protection Agency (HPA).“If that ability is lost through resistance, then medicine will take a great step backwards.”HPA guidelines for all consultant medical microbiologists and infection control specialists across Britain will advise how hospitals should try to detect carbapenem-resistant bacteria, and stress how practices such as screening and isolating high risk patients can help contain infection spread.The advice was drawn up after enquiries from specialist doctors about use of antibiotics after a superbug involving New Delhi metallo-beta-lactamase, or NDM-1, was found last year to have spread to Britain from Asia.“The emergence of carbapenem resistance is a major public health concern and we hope this new guidance will help infection control specialists ... recognize, treat and prevent infections caused by bacteria with these resistances,” Livermore said.First described in 2008, NDM-1 is an enzyme that destroys carbapenems, also known as a carbapenemase. It has been found in a variety of bacterial types, including the Enterobacteriaceae family, Klebsiella and E. coli, all of which are common and can cause a range of infections.Scientists from the Stockholm-based European Center for Disease Prevention and Control (ECDC) said last November that around 77 cases of infections involving NDM-1 had been detected in 13 European countries.A US expert publised a paper last month saying that cases of Enterobacteriaceae-containing NDM-1 had been found in the United States, Israel, Turkey, China, India, Australia, France, Japan, Kenya, Singapore, Taiwan and the Nordic countries.Aside from NDM-1, other carpabenemases have also been detected in Britain and worldwide, the HPA said, including one known as Verona Imipenemase (VIM), another called Klebsiella pneumoniae carbapenemase (KPC) and another called OXA-48.Experts have been warning for years that poor hospital practices and the overuse of antibiotics will boost the spread dangerous bacteria, but practices are changing only slowly.The World Health Organization (WHO) now says there is an urgent need for new antibiotics to be developed, but drug firms are often reluctant to invest heavily into developing such drugs, given that they are often reserved for only the sickest patients and are therefore likely to generate only modest sales.
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