Scanning electron microscopy image of C. difficile in the gut of an infected animal. Credit: University of Sheffield
Clostridioides difficile (C. diff), a type of bacteria that often affects people who have taken antibiotics, is responsible for around 2,000 deaths a year in the UK.
Researchers from the University of Sheffield and the University of Manchester have discovered that C. diff is able to develop high levels of resistance to vancomycin very quickly: in less than two months, the bacteria can tolerate 32 times the concentration of the antibiotic that would normally be effective. Their research is published in the journal PLOS Biology.
Currently, antibiotics used to treat C. difficile damage beneficial gut bacteria, leading to a high reinfection rate: up to 30% of patients treated with vancomycin experience a second infection within weeks, with the likelihood of further relapses increasing thereafter.
Despite vancomycin’s essential role in the UK healthcare system, routine surveillance for resistance in clinical settings is lacking, meaning resistance could emerge under the radar in hospitals. If widespread resistance were to emerge, it would eliminate this essential treatment option from the UK healthcare system.
Antimicrobial resistance (AMR) has been identified by the World Health Organization (WHO) as one of the major threats to public health and development globally. Bacterial AMR is estimated to have been directly responsible for 1.27 million deaths worldwide in 2019 and contributed to 4.95 million deaths.
Jessica Buddle, PhD student at the University of Sheffield and lead author of the study, said: “Our findings highlight the need for vigilant surveillance of vancomycin resistance in UK hospitals. Uncontrolled resistance could contribute to the large number of patients who experience recurrent infection after successful treatment with vancomycin. Further research is essential to inform health policy and determine whether vancomycin remains the best treatment option.”
“Our ongoing work aims to understand the extent and mechanisms of resistance development, to simulate these conditions within the complex ecosystem of the human gut, and to collaborate with UK epidemiologists to identify potential resistance signatures in hospitals.
“These efforts are essential to avoid a future where antibiotics are no longer a viable option for treating bacterial infections and where infections that are easily treatable today become deadly again.”
Although this rapid evolution is concerning, resistant strains have shown reduced overall adaptability, potentially limiting their clinical threat. Resistant strains also frequently exhibited sporulation defects. Sporulation is essential for the transmission of C. diff from person to person and its survival on hospital surfaces.
Future work will aim to understand this interaction between resistance and the bacteria’s ability to cause serious disease. Researchers will be able to use this knowledge to improve surveillance of emerging resistance in hospitals.
More information:
Jessica E. Buddle et al., Identification of high-level vancomycin resistance pathways in Clostridioides difficile that result in high fitness costs in key pathogenicity traits, PLOS Biology (2024). DOI: 10.1371/journal.pbio.3002741
Provided by the University of Sheffield
Quote: Scientists Discover Superbug’s Fast Path to Antibiotic Resistance (2024, August 15) Retrieved August 15, 2024, from
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