New research reveals the surprising factors fueling the spread of Treatment-resistant E. coli and other superbugs, reshaping our understanding of microbial threats.
An analysis of the past two decades reveals a surge in antibiotic resistance in the UK and Norway. Contrary to previous assumptions, the analysis underscores that the rise cannot be solely attributed to antibiotic usage, indicating the presence of additional contributing factors.
For the first time, a comprehensive analysis of antibiotic use’s impact on the rise of treatment-resistant bacteria has been conducted over the last two decades in the UK and Norway.
While acknowledging the role of increased drug use in spreading superbugs, researchers from the Wellcome Sanger Institute, the University of Oslo, and the University of Cambridge reveal that antibiotic use is not the sole driver.
The study, published in the Lancet Microbe, included a high-resolution genetic comparison of bacteria. Over 700 new blood samples were compared with nearly 5,000 previously sequenced bacterial samples to unravel the factors influencing the spread of antibiotic-resistant Escherichia coli (E. coli).
The findings indicated that antibiotic use does drive an increase in treatment-resistant bacteria in certain cases, but the impact varies depending on the type of broad-spectrum antibiotic used.
Recognizing all of the key causes of antibiotic resistance will help us get a better understanding of how these bacteria spread and what prevents them. This might potentially better influence public health measures that take a holistic perspective of the environment to help prevent the development of antibiotic-resistant illnesses.
E. coli, a common cause of worldwide bloodstream infections, poses an added challenge for healthcare providers due to increasing antibiotic resistance, particularly in multi-drug-resistant (MDR) cases. In the UK, over 40% of E. coli bloodstream infections resist a key antibiotic used in serious hospital infections.
While previous studies have highlighted an association between antibiotic use and increased MDR frequency, this new research, spanning almost two decades, directly compares different E. coli strains between the UK and Norway. The study underscores the complex interplay of factors, indicating that the widespread use of one type of antibiotic may not yield the same effects in different countries.
Through an analysis of nearly two decades of data, researchers discovered a correlation between antibiotic usage and increased resistance in certain instances, contingent on the specific type of antibiotic employed. Notably, one category of antibiotics, non-penicillin beta-lactams, was administered three to five times more on average per person in the UK compared to Norway, resulting in a heightened prevalence of infections caused by a specific multi-drug resistant E. coli strain.
Interestingly, despite the UK’s more frequent use of the antibiotic trimethoprim, the analysis did not reveal elevated resistance levels when comparing common E. coli strains found in both countries.
The study also highlighted that the survival of multi-drug resistant (MDR) bacteria relied on the strains of E. coli present in the surrounding environment. Consequently, due to various selective pressures in different areas, researchers concluded that assuming the widespread use of a particular antibiotic will yield similar effects on antibiotic-resistant bacteria across different countries is not valid.
Emphasizing the need for ongoing research, scientists stress that their findings underscore the importance of identifying additional factors driving the spread of E. coli and other clinically significant bacteria in diverse ecological settings.
Further investigation is crucial to comprehensively understand the collective impact of antibiotics, travel, food production systems, and other elements influencing the levels of drug resistance within a country.
Enhancing knowledge about strains capable of outcompeting antibiotic-resistant E. coli could pave the way for innovative strategies to curtail the spread. For instance, initiatives aimed at increasing the presence of non-resistant, non-harmful bacteria in a given area show promise as potential interventions.
According to Dr. Anna Pöntinen, co-first author, these new findings “answer some of the long-standing questions about what causally drives multidrug-resistant bacteria in a population.”
Professor Julian Parkhill, another co-author adds: “Our study suggests that antibiotics are modulating factors in the success of antibiotic-resistant E. coli, instead of the only cause.”
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