Rise of Superbugs Puts Everyday Surgical Operations In Jeopardy

Tens of thousands of patients in Britain are struck down by superbugs because antibiotics to protect them during surgery have failed, a global study says.

One in five infections picked up during common operations worldwide is resistant to standard antibiotics, suggests research that reveals how far resistance to drugs has advanced towards a so-called doomsday scenario.

The research also raises fears that performing everyday surgery will become impossible.

Scientists say infections that are resistant to antibiotics are more widespread in the developing world and will make routine operations difficult without urgent global action.

The rise of bacteria that are resistant to antibiotics is a threat to medicine as common infections could lead to deaths if the bacteria become impervious to such drugs.

Surgery is a concern because routine procedures could become too dangerous to attempt if antibiotics given to prevent infection no longer work.

Dame Sally Davies, the chief medical officer, has warned of a “post-antibiotic apocalypse” where cancer is untreatable and hip replacements or caesareans become impossible because of the threat of superbugs. The World Health Organisation has warned that this will mean the end of modern medicine as we know it.

For the first time an international team has sought to assess the global state of infection during surgery, looking at 13,000 patients in 66 countries undergoing operations such as appendix removal, gallstone surgery, complex hernia repair and treatment for abdominal injuries. Overall 12 per cent contracted infections within a month of surgery, including 9 per cent of 7,339 patients in rich countries, mainly Britain.

Tests showed that 22 per cent of infections were resistant to standard antibiotics given to prevent infection. This figure varied from 17 per cent in the West to 36 per cent in poorer African countries, according to results published in The Lancet Infectious Diseases.

“The level of antibiotic resistance is higher than we would have expected. It’s something we should be concerned about and we need to come up with a strategy to deal with it,” said Ewan Harrison, of the University of Edinburgh, who led the project. “The bugs don’t recognise geographical borders. So even though there are higher levels of antibiotic resistance in other countries that does mean something for the UK as well.”

Dr Harrison said the findings highlighted fears that some operations might become too risky to attempt. “It does underline that concern. It is a concern for the future if antibiotic resistance continues to increase. It may be that we get to a point where we can’t give antibiotics that are effective in preventing infection.”

The study looked specifically at gastro-intestinal surgery, which is carried out a million times a year in British hospitals and where infection is likely to be more common. However, Dr Harrison said the results could apply to many more of the five million surgical procedures carried out in Britain each year. “It is reasonable to generalise beyond the patients we looked at. The same conclusions that we’ve drawn from this could be applied tentatively to other parts of surgery,” he said.

Almost 5 per cent of patients with an infection died after surgery, compared to 1.5 per cent without. They also stayed in hospital for a week on average, more than three times as long as those people who avoided infection.

Nicholas Brown, a consultant medical microbiologist at Addenbrooke’s hospital in Cambridge and director of the campaign group Antibiotic Action, said the findings were a sign that standard preventative antibiotics were failing. He said: “The doomsday scenario, the end of the antibiotic era, is in some countries only a theoretical possibility but in other countries it is beginning to have a very significant impact.”

Chris Smyth, Health Editor, The Times. February 14 2018

Click here to read the full paper