Transplants and cancer treatment 'under threat' from superbug rise One bug, New-Delhi metallo-1, an enzyme which attaches to E.coli bacteria but can jump to other species, has increased dramatically in the last five years. It is brought into Britain predominantly by people travelling to the Indian sub-continent for surgery, those who have been treated in hospital there when they have fallen ill while on holiday and people with family connections there who are treated in both countries often. Prof Livermore, director of antibiotic resistance monitoring at the HPA, said that in 2010 the HPA found one, two or three cases of NDM-1 a month, and now the official laboratory is finding finding that many every week. E.coli can cause gastroenteritis, urinary-tract infections and more severe conditions, such as meningitis, serious kidney problems, blood poisoning and pneumonia. Official figures show there were just seven cases found in England in 2008, which increased to 57 in 2011. In the first nine months of this year there were 74 cases already. Bacteria carrying NDM-1 can only be treated with a handful of antibiotics, most of which are old and were discarded years ago because they are toxic. As well as NDM-1, there are other multi-drug resistant organisms being imported into Britain. Drug-resistant TB is already a major problem but other new ones are entering the country too. Prof Livermore said one called Oxa48 has been found on people being treated from the north African conflicts and there is 'international concern' about soliders from the Iraq and Afghanistan wars being repatriated carrying resistant Acinetobacter bacteria. Prof Livermore also warned that patients with blood poisoning were becoming increasingly difficult to treat because it is so urgent they receive antibiotics quickly. Doctors have to treat them 'blind' without knowing what bacteria is causing the infection and if it is resistant, as test results curenlty take two days. Prof Livermore said: "If you get it wrong and chose the wrong antibiotic you lose two days and the mortality rate roughly doubles." So they resort to using the most powerful class of antibiotics, the carbapenems, straight away. Prof Livermore said this is driving resistance to this 'last resort' antibiotic and it may be less than ten years before there is widespread resistance to that group as well. It is like erosion on the East coast. How long before your house falls off the cliff? How long have we got left with carbapenems? Certainly years, not decades," he said. He said it was vital that doctors assess the risks of each patient and if they are likely to be infected with a resistant bug but also called on more investment into the development of new antibiotics and rapid diagnostic tests. Using genetic based methods instead of growing bacteria in the laboratory can mean test results are available in six hours instead of 48, but this technology is still in its infancy, he said. In the meantime the best the NHS can do is monitor and screen any patient who has recently been treated in hospital abroad, isolate them quickly if they are found to have an infection and impose strict control measures to limit the spread. Prof Laura Piddock, director of Antibiotic Action, said official figures were often the tip of the iceberg as only infections that entered the bloodstream were collected. She said: "Doctors are facing patients now with infections that are extremely difficult to treat. They are faced with difficult decisions because they have to use very unpleasant drugs that can cause horrible side effects. This is happening now and we urgently need new drugs and faster ways of testing for what infections people have. Experts at the World Health Organisation echoed concerns over resistance to carbapenems and warned that the lack of regulation of the drug, in Eastern European countries where many antibiotics are available over-the-counter, will 'worsen the problem'. Ms Zsuzsanna Jakab, WHO Regional Director for Europe, said: "Since their discovery over 70 years ago, antibiotics have kept most of us alive by overcoming bacterial infections that could otherwise have been fatal. The use of antibiotics - and vaccines - has lengthened our life-spans by 20 years on average. If we want to retain this medical miracle, we must fully understand when antibiotics work and do not work, and act accordingly. This is a matter for everybody, from those who set policies and strategies, carry out research, and produce and distribute antibiotics to those who prescribe and use them. The warnings came ahead of European Antibiotic Awareness day on Sunday.