LONDON // A type of killer superbug resistant to antibiotics has become prevalent in the UAE and across Arabian Gulf countries, according to a new study.
Researchers say their findings show the importance of good hygiene in hospitals to prevent outbreaks of diseases that are difficult to treat.
The study found that forms of the bacterium Acinetobacter baumannii resistant to broad-spectrum antibiotics were present across the GCC, including in Abu Dhabi, Saudi Arabia, Kuwait, Bahrain and Oman. A. baumannii has been linked to fatal hospital-acquired infections, and earlier studies have identified resistant forms in other parts of the Middle East.
Published in the Journal of Clinical Microbiology, the study was led by Hosam Zowawi, a Saudi PhD student at the University of Queensland in Australia.
While the researchers expected to find drug-resistant bacteria across the GCC, he said the presence of a particular clone of A. baumannii was “a very unusual finding” as previously specific types had only been seen spreading within individual hospitals.
“The thing that doesn’t make sense is how come we find bacteria [in one part of the region] that are exactly identical to the bacteria isolated from other parts of the Arabian peninsula,” he said.
He said a key question raised by the research was how the drug-resistant bacteria were able to spread so extensively. The widespread use of antibiotics in cattle and poultry farms may be a factor.
“Any [drug-resistant bacteria] that exist in an agricultural setting will definitely find their way into hospitals,” he said.
This meant that it was important that the research was extended to settings outside hospitals.
In the UAE, the drug-resistant bacteria were detected at Zayed Military Hospital in Abu Dhabi, although Mr Zowawi said their wide prevalence meant they were likely to also be found at other hospitals in the country.
However, another of the paper’s authors, Dr Hanna Sidjabat, also of the University of Queensland, said that the overall prevalence of antibiotic-resistant forms of A. baumannii shown in the study was “not really surprising”. A lack of research may have meant that the spread of such bacteria had not been appreciated.
The spread of antibiotic resistance among bacteria has concerned the medical profession for decades. Clinicians are advised to use antibiotics sparingly because their use kills off only the resistant types of bacteria, leaving non-resistant forms to multiply and become more prevalent, eventually making the antibiotics ineffective.
The drug-resistant form of A. baumannii first came to international attention when US soldiers being treated for wounds suffered in the Iraq war became infected, and at the time it was dubbed “Iraqibacter”.
Despite resistant forms becoming more common, there is limited research into developing antibiotics to replace those that have become obsolete.
“Developing new antibiotics will take years and [then] there are new resistance mechanisms. It’s kind of running in a circle,” said Dr Sidjabat.
Instead, she said, the focus should be on preventing the spread of infections in hospitals, and being cautious about using antibiotics.
“I think the hospital cleaning procedures will be the first target – appropriate cleaning and precautions in handling patients, and the healthcare people will not spread the bug through their hands,” she said.
The recently published study resulted from collaboration between scientists across the Gulf. Researchers at Zayed Military Hospital, as well as universities or hospitals in Saudi Arabia, Qatar, Bahrain and Kuwait, all took part.
Further studies could help to identify the source of the particular antibiotic-resistant clones of A. baumannii detected, researchers said, and why they have been able to spread across the region and infect hospitals.
This could help to highlight ways in which their spread could be limited.
The latest research looked at forms of A. baumannii that are resistant to a class of antibiotics called carbapenems, an example of which is an antibiotic called imipenem, discovered in 1980.
Concern in the UAE about the spread of bacteria resistant to other types of antibiotic has been running high for a number of years. In 2012, for example, a conference was told that the number of infections in Abu Dhabi caused by the MRSA superbug was at “a very concerning high level”.
As with A. baumannii, MRSA, the full name Methicillin-resistant Staphylococcus aureus, is commonly associated with outbreaks in hospitals. The infections it causes can prove fatal.
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