The super bacteria threaten Europe

BRUSSELS - There are concerns of both exotic viruses that look from time to time horizon and those of influenza pandemic that could give rise to far more serious than H1N1, but in Europe there are already 25,000 infections that are the dead ' years and against which even modern medicine, with all its technology and its pharmacological armamentarium, it turns out helpless are the diseases by microorganisms resistant to antibiotics, a threat which no longer involves only the sick in hospital.

DATA- The data presented yesterday in Brussels, on the occasion of the Day to raise awareness for the proper use of antibiotics, by Marc Sprenger, Director of the European Centre for Disease Control (ECDC), are disturbing. The warning covers the range of organisms but also the increase in Italy of strains of antibiotic-resistant Klebsiella pneumoniae. In itself, the bacterium is a common cause of respiratory infections and urinary tract, but it becomes very threatening when not responding to medicines. "In Italy is growing significantly the proportion of infections caused by Klebsiella pneumoniae that you can not heal even with the carbapenem group of drugs, medicines to be administered into a vein, in a hospital setting, which is a bit 'in the last resort these cases, "explained the expert. Until 2009, the problem seemed confined to Greece, where more than half of Klebsiella isolated in the laboratory had these characteristics, in Italy there were only sporadic reports little more than, less than 5% of the total. But in a few months these resistances have spread like wildfire, so much so that, in 2010, patients who do not even responded to this treatment so aggressive they were between 10 and 25%. The germ can be transmitted from one patient to another by medical staff, when this does not meet the necessary hygiene standards, but may be present, without giving any problems, even outside the hospital.

STORIES- This is the case of a Norwegian lady, whose story was told at the meeting organized by the European Commission to present their new action plan to combat the threat posed by these infections. Lill-Karin had a car accident during a trip to India, where he was operated on and probably contracted the dangerous micro-organisms through a contaminated catheter. When back in Norway was controlled, as all patients from abroad: a system that allows for the Scandinavian countries to monitor the situation. The screening allowed it to recognize right away the presence of antibiotic-resistant germs, which housed the woman without showing signs of infection, but that she could be transmitted to family members: the patient was immediately isolated and subjected to a treatment that can be toxic but in this case I managed to eradicate the germ. "We are accustomed to think of the antibiotic-resistant infections as susceptible to extreme cases only the elderly or compromised in terms of health, perhaps hospitalized in intensive care," says the expert of international renown. "Instead, even a young woman who undergoes a cesarean delivery may be exposed to these risks, if the medical staff is not sufficiently thorough."

CAUSES- But why in the Mediterranean countries, Greece and Italy in mind, these infections are so common? "The first explanation lies in the excessive and inappropriate antibiotic" says Sprenger. "The countries where the problem of resistance is more common are those in which these drugs are consumed more, probably because of cultural reasons: the mistaken belief that these drugs, however, serve better and to treat conditions such as colds and flu first that Instead, it is caused by viruses, are not susceptible to antibiotics. " Use them when not in use, inadequate dosages or for extended periods of time than prescribed by your doctor only serves to select, among all host bacteria in our bodies, those few items randomly mutated to be resistant, so that proliferate undisturbed without having to compete with others, destroyed by drugs. Part of the responsibility, however, must also go to doctors who prescribe them too lightly, pharmacists who sell them without prescription, to veterinarians and farmers who use them in an improper way to keep animals healthy and promote growth, a practice forbidden in Europe by 2006. A significant role, with regard to nosocomial infections, also may have poor sanitary conditions that are still found in some structures, the superficiality with which doctors and nurses observe the recommendations of hygiene or lack of personnel required to cut also on the time for washing hands repeatedly. But the resistance may also depend on the presence of genes able to destroy or inactivate the drug itself and that have the character to be transmitted directly from one bacterium to another. The presence of a few resistant elements is therefore sufficient to arm the other germs before harmless against antibiotics is the case of the gene called NDM-1 ("Metal beta-lactamase New Delhi", the city where for the first time it was isolated). And because germs do not need a passport to cross the frontiers, we must find another way to locate and neutralize them.