Lethal ESBL infection of newborns

High health risks due to antibiotic-resistant germs

04/11/2011

After the death of three premature babies in a Bremen clinic, the discussion is back in full swing for possible hospital infections. Every year, thousands of people become infected with particularly dangerous multidrug-resistant hospital germs during a hospital stay in Germany. For premature babies a special risk because their body is much more susceptible to the infections.

The multidrug-resistant ESBL bacteria have been raging since August at the neonatal intensive care unit at the Frauenklinik Bremen-Mitte. While the antibiotic-resistant bacteria are not a particular health threat to healthy adults, infants - especially premature babies - are at a massive health risk with potentially lethal effects. The apparently already for months a problem with the germs in the Bremen clinic was present and still premature babies were recorded, therefore seems extremely questionable. A total of 15 newborns became infected with the ESBL germs, seven of them are seriously ill, three died as a result of the infection.

ESBL germs relatively widespread
After the deaths of the premature babies in the Bremen clinic, the prosecution now also investigates the suspicion of the negligent homicide. However, it remains completely unclear how the multidrug-resistant bacteria could reach the intensive care unit and infect the preemies in their actually sterile incubators. According to hygiene experts such as Brar Piening, from the Berlin Charité is not necessarily based on a misconduct of the staff, but just as well could one „fateful event“ have led to the infection of preemies. Piening told the „Tagesspiegel“, that also the introduction of the ESBL pathogens by visitors is a conceivable variant. However, antibiotic-resistant germs are often formally bred in clinics. Due to the improper or frivolous use of antibiotics and the lack of compliance with the hygiene regulations, the pathogens repeatedly come into contact with antibiotics and can develop against these resistances. Thus also a selection takes place in favor of the ESBL germs, explained the expert. Hereby ESBL stands for „Extended Spectrum β-lactamases“, which basically says nothing about the bacteria itself, but merely describes a specific enzyme that helps various germs to protect themselves from the attacks of the antibiotic. With the help of the enzyme, ESBL germs can withstand numerous antibiotics. The pathogens are usually no health threat for adults and many people have ESBL germs in their intestines, the experts explained.

Special health risk for premature babies
However, as premature babies' immune systems are not as resilient as adults, and little ones have virtually no contact with microorganisms during their life in the sterile incubator, the ESBL germs pose a massive health threat to them. If the resistant germs infect the weakened organism of the preemies, their defenses are often insufficient to cope with the ESBL bacteria. Antibacterial treatment, which is common in bacterial infections, also does not show the desired effect, so that the pathogens can spread relatively easily in the organism. In addition, the treatment trial with antibiotics often lost valuable time, during which the ESBL pathogens in the body can multiply undisturbed, said Brar Piening. The smaller the premature babies are, the greater the health risk for them, according to the hygiene specialist.

Multidrug-resistant germs are spreading
Although the ESBL germs are not usually very aggressive in themselves, according to the experts in the clinics they are becoming a growing threat. Because „ESBL pathogens are by far the most rapidly growing pathogens“, The number of ESBL infections in intensive care units almost quintupled between 2003 and 2009, Piening explained „Tagesspiegel“. The resistant ESBL germs „do not do anything with healthy people, everything with patients“, according to the expert's assessment of the health risks of the ESBL germs. The transmission path usually runs via direct contact, which is why hand disinfection on neonatal intensive care units is extremely important, explained Piening. The skilled person admitted, however, that adherence to hand disinfection was not always possible, since in acute emergencies such as the suspension of the heartbeat or breathing every second counts and there is no time for hand disinfection. According to the hygiene specialist, an increased risk of infection also exists if the staffing level is too low and the stations are overcrowded. For the increased occurrence of antibiotic-resistant germs, the expert not only responsible for the conditions in the clinics, but also refers to the improper use of antibiotics in livestock farming. This also promotes the emergence of multidrug-resistant pathogens, which can then skip on humans, so the statement of the expert. (Fp)

Also read:
Alternatives to antibiotics from naturopathy
There are no mild antibiotics
Resistant Salmonella bacteria discovered
Hospital germs: Staphylococci prefer blood
Risk of infection in the hospital
Resistant bacteria in German hospitals

Image: Michael Bührke