It’s the little things that could take us down. MARK CUBEY gets bacterial.
Humanity faces its most likely extinction, or at least severely depletion, by the myriad “natural” disasters caused by anthropogenic climate breakdown, allowed to happen by unaddressed CO2 emissions and general governmental slackness and inability to think beyond the next electoral cycle.
Then again, nuclear mishap or conflagration is also a serious possibility (Trump has the codes! Pakistan/India could escalate any time!). It’s astonishing that the fear felt in the 1980s about the looming possibility of nuclear war is almost completely absent now amid a complacent or possibly shell-shocked population.
But right now, in the Hutt Valley, a stealthy and equally likely vector for the eradication of humanity is thriving: CPE.
The Hutt Valley DHB has identified five carriers of Carbapenam Producing Enterobacteriaceae (above), a family of bacteria resistant to nearly all antibiotics – two people in hospital, and three in the community.
Antibiotic resistance is one of the biggest threats to global health, food security, and development today.
Failure by slack patients to continue courses of antibiotic treatment as prescribed, has allowed tiny and cunning bacteria to become increasingly resistant to drugs, and develop and spread that resistance around the world.
Without properly functioning antibiotics, infections such as pneumonia, tuberculosis, blood poisoning, gonorrhoea, and food-borne diseases can become impossible to treat.
There have been very few new classes of antibiotics in the past 20 years. Unless that situation changes, we will encounter more bacteria that we can’t treat effectively. And that could take humanity back centuries when it comes to saving lives.
The most widely known “hospital superbug”, Methicillin Resistant Staphylococcus Aureus (MRSA) is one of the more common antibiotic-resistant infections; CPE is a newcomer. It is resistant to carbapenems, a group of antibiotics often used to treat complex infections, or when other antibiotics have been ineffective.
“CPE is extremely rare in New Zealand, but also concerning because of its resistance to antibiotics, which is why we are alerting our community,” says Hutt Valley DHB infectious diseases senior medical officer Dr Matthew Kelly.
While the DHB are taking the presence of CPE in the community extremely seriously, Kelly is calling for awareness rather than alarm.
“In all but one person it was an incidental finding, and hasn’t resulted in illness. The one person who did have illness has been successfully treated.
“We are closely managing the five patients and working with their health care professionals. We are contacting those people who may have been in contact with the two patients who were in hospital to provide them information about CPE,” he said.
The first confirmed laboratory result of CPE was on Saturday 25 August and the most recent case was identified on Friday 12 October. Patients and their health professionals were informed of the results immediately. The DHB has assessed the risk to the general public as being low.
“The bacteria can be in your gut for months to years and will usually cause no harm,” said Kelly.
CPE is found in the gut bacteria of a carrier and is transferred by touch to surfaces, skin or food when that person hasn’t washed their hands properly after going to the toilet. Someone else can then unknowingly transfer the bacteria to their mouth.
“There is no effective way to remove it from the gut and it may stay for longer if you take other antibiotics. The bacteria can cause infection in vulnerable people if it gets into the wrong place such as in the urine or a wound from surgery,” said Kelly.
“The first line of defence against any bacteria is thorough and frequent handwashing, especially after going to the toilet, and before preparing and eating food.”
Most previous cases of CPE in New Zealand, around 50 this year, have been linked with overseas travel.
Despite Dr Kelly’s calming words, this cluster of cases appears to have originated in the community.
Hutt Valley DHB has not, to date, been able to confirm the source of infection.