Fatal ESBL infection in newborns

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High health risks due to antibiotic-resistant germs

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

The multi-resistant ESBL bacteria have apparently been raging in the neonatal intensive care unit of the Bremen-Mitte women's clinic since August. Although the germs resistant to numerous antibiotics are not a particular health threat for healthy adults, the pathogens are a massive health risk with potentially fatal effects for toddlers - especially premature babies. It therefore seems extremely questionable that there had apparently been a problem with the germs in the Bremen clinic for months and that premature babies were still admitted. A total of 15 newborns were 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 premature deaths in the Bremen clinic, the public prosecutor's office is now investigating suspected negligent killing. However, it remains completely unclear how the multi-resistant bacteria can get into the intensive care unit and how they can infect premature babies in their actually sterile incubators. According to hygiene experts such as Brar Piening, the Charité in Berlin does not necessarily assume that the staff have behaved incorrectly, but that a “fateful incident” could have led to the infection of premature babies. Piening told the “Tagesspiegel” that the introduction of ESBL pathogens by visitors was also a conceivable variant. However, antibiotic-resistant germs are often formally cultivated in the clinics. Due to the improper or careless use of antibiotics and the lack of compliance with the hygiene regulations, the pathogens come into contact with antibiotics again and again and can develop resistance to them. A selection in favor of the ESBL germs also takes place, the expert explained. ESBL stands for "Extended Spectrum β-Lactamases", which basically says nothing about the bacteria themselves, but simply describes a special enzyme that helps different germs to protect themselves from the attacks of the antibiotics. With the help of the enzyme, ESBL germs can withstand numerous antibiotics. However, the pathogens are usually not a health threat for adults and many people have ESBL germs in their intestines, the experts explained.

Special health risk for premature babies Because the immune system of premature babies is far from being as resistant as in adults and the little ones have practically no contact with microorganisms during their life in the sterile incubator, the ESBL germs are a massive health threat for them. If the resistant germs infect the weakened organism of premature babies, their defenses are often not sufficient to cope with the ESBL bacteria. An antibiotic treatment that is common for bacterial infections also does not have the desired effect, so that the pathogens can spread relatively easily in the organism. In addition, trying to treat antibiotics often means that valuable time is lost during which the ESBL pathogens can multiply undisturbed in the body, explained Brar Piening. The smaller the premature babies, the greater the health risk for them, according to the hygiene specialist.

Multi-resistant germs spread Although the ESBL germs are usually not particularly aggressive per se, according to the experts in the clinics they are becoming a growing threat. Because "ESBL pathogens are by far the fastest growing hospital pathogens", whereby the number of ESBL infections in intensive care units increased almost fivefold between 2003 and 2009, Piening explained to the "Tagesspiegel". The resistant ESBL germs "do nothing for healthy people, everything for sick people", according to the expert's assessment of the health risks of ESBL germs. The transmission path is mostly direct contact, which is why hand disinfection in newborn intensive care units is extremely important, explained Piening. However, the expert admitted that adhering to hand disinfection is not always possible, since in acute emergencies such as the failure of the heartbeat or breathing, every second counts and there is no time for hand disinfection. According to the hygiene specialist, there is an increased risk of infection even with insufficient staff and in overcrowded wards. However, the expert not only blames the conditions in the clinics for the increased occurrence of antibiotic-resistant germs, but also refers to the improper use of the antibiotics in livestock farming. This also promotes the emergence of multi-resistant pathogens, which can then also spread to humans, according to the expert. (fp)

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

Image: Michael Bührke / pixelio.de

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