Gram negative infections: tough targets ahead

The Health Secretary, Jeremy Hunt, recently launched plans to halve the number of gramnegative bloodstream infections by 2020. E. coli infections – which represent 65% of gram-negative infections – killed more than 5,500 NHS patients last year and are set to cost the NHS £2.3 billion by 2018. There is also large variation in hospital infection rates, with the worst performers having more than five times the number of cases than the best performing hospitals. Among the plans to prevent NHS infections include: 

Given this increased focus on gram negative infections, the subject was high on the agenda at the recent Knowlex Infection Prevention & Control conference, held in London. Dr Susan Hopkins, healthcare epidemiologist, Public Health England, and chair of the English surveillance programme for antimicrobial utilisation and resistance (ESPAUR), offered an insight into the prevalence of gram negative healthcareassociated infections and the issues this presents for healthcare professionals. 

Dr Hopkins highlighted the fact that gram negative infections are a “major driver for antibiotic resistance” and the number of people affected by antibiotic-resistant gram negative infections continues to increase. Gram-negative bacteria, a class of bacteria including Enterobacteriaceae, are of particular concern, as resistance to multiple drugs is now accumulating in these species. While the most serious multi-drug resistant (MDR) infections are in healthcare settings, where vulnerable patients are subject to a high antibiotic selective pressure, these resistant bacteria are now also spreading within the community.