Spread of Antibiotic-Resistant E. Coli Superbugs Linked to Toilet Hygiene

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New research published in The Lancet Infectious Diseases indicates that poor toilet hygiene is more likely to spread antibiotic-resistant E. coli than food.

As a news release on the research notes, E. coli has become considerably more antibiotic resistant in recent years in humans and animals. Particularly noteworthy are those strains of the bacteria with extended spectrum beta-lactamases (ESBL), which are enzymes that destroy many important penicillin and cephalosporin antibiotics.

Researchers set out to determine whether antibiotic-resistant E. coli that cause bloodstream infections are passed from person to person or acquired via the food chain. The scientists pursued this research by sequencing the genomes of resistant E. coli from multiple sources across the United Kingdom. These included human bloodstream infections, human feces, human sewerage, animal slurry, and variety of meat, fruit and salad.

The central conclusion: There was little crossover of ESBL-E. coli from animals to humans.

Lead author Prof. David Livermore, from the University of East Anglia's Norwich Medical School, said, in the release: "… the likeliest route of transmission for ESBL-E. coli is directly from human to human, with fecal particles from one person reaching the mouth of another. … We need to carry on cooking chicken well and never to alternately handle raw meat and salad. There are plenty of important food-poisoning bacteria, including other strains of E. coli, that do go down the food chain. But here — in the case of ESBL-E. coli — it's much more important to wash your hands after going to the toilet. … And it's particularly important to have good hygiene in care homes, as the most of the severe E. coli infections occur among the elderly."

The research — titled "Extended-spectrum β-lactamase-producing Escherichia coli in human-derived and foodchain-derived samples from England, Wales, and Scotland: an epidemiological surveillance and typing study" — was published in The Lancet Infectious Diseases on Oct. 22, 2019.

Antibiotic for Complicated UTIs Receives Approval From FDA Panel

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A new antibiotic for complicated urinary tract infection (cUTI) has received approval from the U.S. Food and Drug Administration's (FDA) Antimicrobial Drugs Advisory Committee, according to a news release.

The investigational antibiotic cefiderocol is made by Shionogi & Co. of Japan. The FDA panel recommended — by a vote of 14-2 — approval of the antibiotic for the treatment of cUTI, including pyelonephritis, in patients with limited or no alternative treatment options.

As the release notes, the Advisory Committee provides the FDA with independent advice and recommendations. The FDA is not bound by the committee's guidance but takes its recommendation into consideration when reviewing investigational medicines.

Cefiderocol was designated as a qualified infectious disease product (QIDP) by the FDA. Under this designation, cefiderocol was previously granted "fast-track" status for FDA approval for its potential as a new antibiotic to treat serious or life-threatening conditions and address unmet medical needs.

While the FDA panel provided its recommendation, there were caveats, reports MedPage Today. These included suggestions for the inclusion of a boxed warning discussing potential mortality risk, with mention of a special risk among patients with hospital-acquired bacterial pneumonia or ventilator-associated bacterial pneumonia, and the conducting of additional research and studies.

If cefiderocol receives FDA approval, it will be marketed under the brand name FETROJA.

CDC Shares New Infection Prevention and PPE Research

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In conjunction with International Infection Prevention Week, the Centers for Disease Control and Prevention (CDC) has announced the availability of new research into infection prevention and the use of personal protective equipment (PPE).

The research is available as a supplement to the October issue of Clinical Infectious Diseases. Titled "Personal Protective Equipment for Preventing Contact Transmission of Pathogens: Innovations from CDC's Prevention Epicenters Program," it is composed of more than a dozen CDC-funded, in-depth studies on recent PPE work in U.S. healthcare settings. The research, CDC states, provides evidence to improve routine use of PPE and prevent contact transmission of infectious diseases in healthcare settings.

Topics covered in the studies include:

  • antibiotic-resistant bacteria in hospitals;

  • doffing;

  • gown design;

  • hand hygiene;

  • glove decontamination; and

  • biocontainment unit design.

More specifically, the research was supported by the CDC's Prevention Epicenters Program, a 20-year-old research program intended to implement strategies to improve healthcare quality and patient safety.