National hunt for superbug E-Coli is on

Think of this next time you flush: a government-funded study is about to start poking sewers, supermarket shelves and farmyard slurry in search of one of the most menacing drug resistant superbugs.

The research project, being led by Public Health England, is the largest ever project of its kind to understand where resistant bacteria come from, how they move around, and what can be done to stop the emerging.

The researchers are targeting a bug called ESBL E-coli. E-coli are extremely common, living in the guts of all of us, and they’re usually harmless. But if they get into the wrong place, or a wound, they can cause infection.

And if they carry the ESBL resistance genes, they can be fatal. The ESBL enzymes can break down nearly all antibiotics, including some of the most powerful, called cephalosporins.

Of the 30,000 potentially life-threatening bloodstream infections every year, 3,000 are caused by ESBL bacteria. Doctors only have a handful of antibiotics that are effective against them.

“Because it’s carried in the gut, E-coli is the perfect vehicle for carrying resistance out of the hospital into the community and back again,” said Neil Woodford, head of the Antimicrobial Resistance and Healthcare Associated Infections Reference Unit at PHE.

Since about 2001 ESBL E-coli have been showing up in UK hospitals. They are now an ever-present problem for doctors. But what isn’t clear is where the bacteria are coming from.

They can only become resistant to antibiotics if they are regularly exposed to them. So are they lurking in our hospitals? In the guts of healthy people? Of farm animals, often given high doses of antibiotics themselves?

This latest study intends to find out.

“We know we can find ESBL E-coli in non-human sources, what we don’t fully understand is the public health risk they pose. And that’s what we hope to disentangle,” said Professor Woodford.

They will compare the samples from the environment with those taken from hospital infections in five different regions of England and Wales. They hope that by genetically sequencing the bugs, they will be able to identify how they make it into hospitals and into patients causing infections.

A leading hypothesis is that some of us carry the superbugs in our guts where they cause no harm – only becoming a problem if they spread into a wound.

But the researchers also want to know if use of antibiotics on farms and contamination of meat is also a source.

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