There has been a "worrying increase" in resistance to important antibiotics, according to researchers from the Public Health Laboratory Service (British Medical Journal 2000;320:213).
Dr Mark Reacher (consultant epidemiologist, PHLS communicable disease surveillance centre) and colleagues have conducted an analysis of reports of bacteraemia and antibiotic resistance made to the centre by microbiology laboratories in England and Wales from 1990 to 1998. Blood isolates judged to be clinically significant are reported to the PHLS by microbiologists.
In every age group, Staphyloccoccus aureus was one of the top five causes of bacteraemia. A steep decline in the number of reports of Haemophilus influenzae was seen from 1992, which the authors suggest followed the introduction of the Hib immunisation.
A rise in antibiotic resistance was seen in blood isolates. For example, the number of reports of methicillin resistant Staphyloccocus aureus (MRSA) rose from 1.7 per cent in 1990 to 34 per cent in 1998. The increase in resistance emphasises the importance of "sound hospital infection control, rational prescribing policies and the need for new antimicrobial drugs and vaccines," the authors say. Laboratory reporting provided "valuable information on trends and antibiotic resistance in bacteraemia", they conclude.
Professor S. G. B. Amyes (professor of medical microbiology, University of Edinburgh) comments that the rise in bacterial resistance is because there have been no new classes of antibiotics since the 1960s (Ibid, p199). No new "clinically useful structures" have been discovered since 1961 and all the drugs launched since then have been modifications of existing drugs, he says.