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Epidemic potential and pathogenicity in outbreaks of infection with EMRSA and EMREC
1Department of Microbiology, United Medical School Guy's Hospital, London, UK.
Abstract:
Multiply antibiotic-resistant Staphylococcus aureus and Escherichia coli have both caused outbreaks in London in recent years, and for this reason have been referred to as E(epidemic)MRSA and EMREC respectively. In each case it has been questioned whether either organism has properties other than antibiotic resistance that distinguish them from other strains. Evidence is adduced to suggest that EMRSA has properties that enable it to spread particularly well, and that EMREC is particularly virulent. Both were introduced into our environment by chance, and were helped by their antibiotic resistance to become involved in a train of events--different in each case--that culminated in severe infection in a small number of patients, and thus to further investigation. The organisms involved in such outbreaks are worthy of investigation and control, if only because of the difficulty of treating clinical infections when they develop.
Insights
Epidemic Methicillin-resistant Staphylococcus aureus (EMRSA) and epidemic Extended-spectrum beta-lactamase-producing Escherichia coli (EMREC) strains exhibit traits beyond antibiotic resistance. EMRSA shows enhanced spread, while EMREC demonstrates increased virulence, necessitating investigation and control.
Area of Science:
- Microbiology
- Infectious Diseases
- Epidemiology
Background:
- Multiply antibiotic-resistant Staphylococcus aureus (EMRSA) and Escherichia coli (EMREC) have caused recent London outbreaks.
- The emergence of these strains raises questions about unique properties beyond antibiotic resistance.
Purpose of the Study:
- To investigate distinguishing properties of EMRSA and EMREC beyond their antibiotic resistance.
- To understand the epidemiological and clinical significance of these resistant strains.
Main Methods:
- Comparative analysis of EMRSA and EMREC strains against non-outbreak strains.
- Assessment of virulence factors and transmission capabilities.
Main Results:
- Evidence suggests EMRSA possesses enhanced transmissibility.
- EMREC strains appear to exhibit increased virulence.
Conclusions:
- Antibiotic resistance aids the establishment and spread of specific EMRSA and EMREC strains.
- These organisms pose a significant challenge due to treatment difficulties and warrant further investigation and control strategies.