Increase in antibiotic-resistant bacteria hinders treatment of kidney infections

https://www.eurekalert.org/pub_releases/2016-10/uoc--iia100416.php

Public Release: 4-Oct-2016
Increase in antibiotic-resistant bacteria hinders treatment of kidney infections
Researchers recommended development of new medications and new guidelines for treatment
University of California - Los Angeles

The increase in illnesses and deaths linked to medication-resistant bacteria has been well-documented by researchers and received extensive public attention in recent years. Now, UCLA-led research shows how these bacteria are making it more difficult to treat a common but severe kidney infection.

Pyelonephritis -- infection of the kidney usually caused by E. coli bacteria and which can start as a urinary tract infection -- causes fever, back pain and vomiting. About half of people infected require hospitalization. If not treated with effective antibiotics, it can cause sepsis and death.

In a UCLA-led study based on data from 10 large hospital emergency departments around the country, almost 12 percent of people diagnosed with pyelonephritis had infections resistant to the standard class of antibiotic used in treatment -- fluoroquinolone. (Cipro and its generic version ciprofloxacin are commonly used medications in this class.) That's up from 4 percent in a similar study conducted a decade ago. In some cities, and among some people with certain risk factors -- such as international travel or recent hospitalization or treatment with an antibiotic -- fluoroquinolone resistance rates exceeded 20 percent.

The new study -- published in the September issue of Emerging Infectious Diseases -- also documents the emergence of infections caused by a specific strain of E. coli that is resistant to additional types of antibiotics, severely limiting treatment options. That strain, dubbed ESBL for the antibiotic-destroying enzymes it produces (extended-spectrum beta-lactamases), was not detected in the previous study. The enzymes were first detected in 1979 and are most often found in developing nations.

Currently, there are only a few intravenous antibiotic options to treat ESBL-related infections, and no oral antibiotics that are consistently effective.

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