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Patients bring highly resistant intestinal germs to the clinic


Every 8th patient brings multi-resistant ESBL germs to the clinic

According to health experts, up to 15,000 people die from hospital infections in Germany every year. Some estimates even assume up to 30,000 deaths. Scientists have now been able to show that many patients already bring highly resistant germs with them when they are admitted to the clinic.

Dangerous hospital infections

For years, health experts have pointed out that better infection protection is required in German hospitals in order to better prevent clinical infections. It is obviously not only problematic that important hygiene regulations are not observed in many facilities. A new study has now shown that many newly admitted patients bring multi-resistant germs to the clinic.

Newly admitted patients bring ESBL germs with them

Scientists from the InfectoGnostics research campus in Jena have now been able to prove in an observational study that every eighth new patient admitted to a clinic already carries so-called ESBL germs.

As it says in a communication, infections with its own ESBL pathogens remained an exception in the study, but the researchers showed that the pathogens could pass on their resistance genes to other bacterial strains in the clinic.

InfectoGnostics scientists from the University Hospital Jena, the industrial partner Abbott and the Leibniz Institute for Photonic Technologies were involved in the clinical study. The results were published in the technical journal "PLOS One".

Resistant to many antibiotics

“ESBL bacteria (“ Extended Beta-Lactamase ”or“ Beta Lactamase with an extended spectrum ”) can cleave the beta-lactamase rings of an important group of antibiotics with an enzyme and render them ineffective,“ explains the Techniker Krankenkasse on their website.

"These enzymes are most common in typical intestinal bacteria such as Escherichia coli and Klebsielles," says the TK.

According to experts, multi-resistant intestinal bacteria are often transmitted via the hands, which is why consistent hand hygiene can save lives.

In the case of immunodeficiency, the germs can lead to an infection

As the University of Jena writes in a message, ESBL act like life insurance for bacteria: once the bacterium is able to form such an enzyme, it can successfully defend itself against numerous antibiotics that are used in clinics and also by the family doctor Come into play.

The result: For several years now, doctors have had to use reserve antibiotics more and more to get infections under control. This cycle means that many antibiotics are already ineffective.

ESBL-forming bacteria do not mainly spread in hospitals, but colonize the healthy intestine primarily through food intake.

Colonization itself is not dangerous as long as those affected are healthy. However, the germs can lead to infections in severe operations or when the immune system is weak.

In the current study, the colonization rate in patients who are newly admitted to the hospital has been examined and evaluated whether it increases due to the hospital stay.

The researchers also analyzed the factors that cause colonization with the pathogen.

Only one patient became infected with their own pathogen

For the study, 1,334 patients were tested for ESBL-forming intestinal germs: first when they were admitted to the clinic, then after the end of treatment and - if possible - again six months after their stay in the clinic.

The results showed how widespread ESBL-forming bacteria are in the population today: in every eight patients tested (12.7 percent), an ESBL germ could be detected when they were admitted to the clinic.

However, the situation is even more dramatic for patients from nursing homes: almost every fourth patient (23.8 percent) already carries the multi-resistant germs in them.

Despite this high colonization rate with ESBL pathogens, actual infections with the 'own' ESBL germ occurred extremely rarely during the hospital stay: In the study, only one patient became infected with the own pathogen.

No reason to give the all-clear

However, the low number of infections in the clinic is not yet a reason for the all-clear, as Dr. Oliwia Makarewicz from the Institute for Infectious Medicine and Hospital Hygiene at the University Hospital Jena explains:

"On the one hand, the number of actual infections in departments such as oncology, geriatrics or the intensive care unit is incomparably higher, because it mainly treats high-risk patients with a weakened immune system," says the scientist.

"On the other hand, we were able to show again in our analyzes that the genetic information for multi-resistance via plasmids can also be transferred to other types of bacteria in the intestine - new multi-resistant pathogens can thus arise very quickly," explains Dr. Makarewicz.

“One has to assume that such colonization germs can pass on the resistance to hospital germs. The role of these small DNA strands in the transmission of resistance has so far been neglected in everyday clinical practice. ”(Ad)

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