Tuesday, 20 Aug 2019

On the trail of the Superkeims


Everything started with a harmless bone fracture, but in the end, the patient was dead. In the body of the Pensioner Klebsiella had pneumoniae germs spread, all approved drugs remained ineffective. All the 26 different antibiotics were administered to Doctors, the woman – without success. The case of the United States almost three years ago shows, how dangerous is Klebsiella pneumoniae.

The bacteria in the human intestine, where they usually cause no problems. The immune system is weakened, however, and the pathogen spread, for example, in the lungs, they can cause life-threatening infections. The Fatal: medications can align against you often nothing.

“Urgent health hazard”

The pathogens are therefore considered to be the fastest-growing threat posed by resistant bacteria in Europe. Between 2007 and 2015, the number of documented deaths increased six – fold, from about 340 to just under 2100. The world health organization (WHO) ranked the Klebsiella pneumoniae germ as an “urgent threat to the health of the people”.

Researchers have now examined how the pathogens spread. For this, they analyzed more than 1700 samples from 244 hospitals in 32 countries, including Germany. The analysis showed that only a few genes for drug resistance are responsible. A total of 70 percent of all the samples decreased to only four excitation lines, the researchers report in the journal “Nature Microbiology”.

The data show that these lines are spread mainly in hospitals – which is precisely where many antibiotics are administered. In more than half of the cases, the researchers found in different samples from a clinic similar genetic variants. “The more resistant pathogens are, the better they can spread in hospitals,” says one of the study’s authors, Hajo Grundmann of the University of Freiburg. “This is very troubling.” Most frequently these pathogens occur in southern Europe, where very often reserve antibiotics to be prescribed.

One of the largest documented outbreaks in Germany between 2010 and 2013 at the University hospital Leipzig. At that time, the pathogen was detected in more than a hundred patients, at least 30 died.

In the case of such outbreaks, Doctors frequently use so-called carbapenems – reserve antibiotics, which are only used when other antibiotics fail. Doctors speak, then, in contrast to resistant or multi-resistant bacteria extremely resistant bacteria (XDR; extreme drug resistant). “We can then Dodge is still in an experimental or in part, very old antibiotics that are associated with many side effects,” says Grundmann, who heads in Freiburg, the Institute for infection prevention and hospital hygiene.

“These pathogens, you don’t get in the tram”

In rare cases, can spread the pathogen, even across national borders, as an analysis of the excitation line ST258/512 shows. The pathogen variant emerged in the nineties in the USA, from there they came to Greece and from there spread further in Germany and the UK. The closely related strain ST512 came, presumably, from Israel to Italy and from there it spread to Spain, Belgium and Austria.

“These pathogens you don’t get in the tram, eating meat, swimming in a lake or on the coast of the Aegean,” stresses Grundmann. “Our observations suggest that the extremely resistant bacteria, especially within individual hospitals, as well as the transfer of patients between geographically nearby hospitals spread.” Patients who were previously in other hospitals at home and abroad, should, therefore, be investigated in a targeted on-resistance down.

That bacterial resistance develops, is a natural process and part of the Evolution: Meet the pathogens to antibiotics, should actually be the death of all. Due to random mutations in the genome, it may be, however, that a few survive, and protection mechanisms against the antibiotics have built up. The excessive use of the drugs in humans and in animal fattening accelerates this process.

In the fight against antibiotic resistance, scientists have already developed effective strategies. These include:

  • Strict hygiene regulations in the hospitals, already resistant pathogens from one patient to the next to wear.
  • Targeted use of antibiotics. Too often, prescribing Doctors, the medications, although the patients don’t even need. Many cold diseases are triggered by viruses, against which antibiotics are ineffective.
  • Proper intake of antibiotics. Here the patients have the responsibility: Who takes the prescribed antibiotic to short or in the wrong, better for bacteria a Chance to the agents to adapt, so that they are no longer able to kill the pathogens.

In summary: bacteria of the species Klebsiella pneumoniae are among the most dangerous pathogens in the world, because they are often against even reserve antibiotics. According to a recent investigation, it spread mainly in hospitals. Rigorous hospital hygiene and the prudent use of antibiotics could prevent further outbreaks.

In the Video: multi-drug resistant pathogens – the fight against killer germs