Antibiotic resistant infections Pokenga whawhai rongoā paturopi

Some bacteria (germs) that cause infections can become resistant to antibiotics. This means some antibiotics will not work and the infection is harder to treat. These include infections caused by MRSA, VRE and the ESBL and CPE groups of bacteria.

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About antibiotic resistant infections

Infections caused by bacteria (germs) are often treated with antibiotics. Over time, some bacteria have evolved to survive antibiotics. The misuse of antibiotics has helped the bacteria to build resistance. This includes antibiotics being: 

  • overused
  • used for diseases that are not caused by a bacterial infection such as colds and flu
  • not taken as prescribed, such as not finishing all the antibiotics.

Bacteria that are resistant to antibiotics are also known as 'superbugs' or multi-drug-resistant organisms (MDRO). MDRO include other germs that have become resistant to drugs including viruses, fungi and parasites.

Infections caused by antibiotic-resistant bacteria are difficult to treat. These types of infection are still rare. But they are increasing in Aotearoa New Zealand, both in healthcare facilities and in the community. They are also a major public health problem worldwide.

Preventing antibiotic resistance

There are several things you can do help prevent further antibiotic resistance developing.

  • Regularly wash your and dry hands.
  • Keep up to date with immunisations.
  • When preparing food, remember the 3Cs to prevent you and your whānau from getting food poisoning — clean, cook, chill.
  • Reduce the use of antibacterial cleaning and other products around your home.
  • Trust your healthcare provider if they say you do not need antibiotics. Ask them about other ways to relieve your symptoms.
  • Only take antibiotics if they are prescribed for you. Do not use or share leftover antibiotics.
  • If antibiotics are prescribed for you, follow your healthcare provider’s advice on when and how to take them.
  • Take any unused antibiotics back to your pharmacy so they are disposed of safely and do not enter the environment.

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Carriers and infections

Many people 'carry' antibiotic resistant bacteria in or on their bodies. But they do not cause harm because they have not caused an infection. This is also known as being 'colonised'. 

If you are a carrier, you may get an infection if:

  • you get a cut, scratch or wound
  • you have an operation or other medical procedure such as an intravenous drip
  • your immune system has been weakened by illness.

People who are carriers may also pass the bacteria onto others who may then also become carriers or may get an infection.

People can pass on the bacteria to others by: 

  • touching them
  • touching something that someone else then touches and transfers the bacteria to their body.

Most antibiotic resistant bacteria are not spread through the air by coughing or sneezing.

Types of antibiotic resistant bacteria

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Enterobacteriaceae is the name given to a family of bacteria that normally lives in our gut (bowel). A well-known enterobacteriaceae is E. coli.

Carbapenems are a group of antibiotics that usually work against these bacteria. Some of these bacteria have become hard to treat because these antibiotics no longer work. CPE is a family of bacteria that have become resistant to carbapenems, as well as many other antibiotics.

Who is at risk of CPE 

CPE infections are rare in Aotearoa New Zealand. When people do get it, they have often picked it up when they have had medical care overseas. CPE is found in the general population around the world, especially in Southeast Asia, India and Pakistan.

Healthy people do not usually get CPE infections. But it is important to know that people without symptoms may carry CPE in their bowel or in a wound.

If you are carrying CPE, you are at risk of getting a CPE infection if you:

  • have an operation (especially on the prostate)
  • need treatment using ventilators (breathing support), catheters (tubes to drain fluids from your body) or intravenous drips
  • have taken some antibiotics for long periods of time.

Effects of CPE

People may not know they are carrying CPE and may never develop a serious infection. But in some people, it can be a serious problem. It can cause:

Treating CPE infections

There are not many options for treating CPE infections, as the bacteria are usually resistant to most antibiotics. It is very important to try to prevent the infection in the first place.

Some bacteria (germs) produce an enzyme called beta-lactamase. This enzyme prevents certain antibiotics from working.

This means infections caused by bacteria that produce this enzyme are more resistant to antibiotics. An infection caused by ESBL-producing bacteria is more difficult to treat. Only a limited range of antibiotics can be used.

Types of ESBL-producing bacteria include E. coli and Klebsiella. Both of these normally live in your bowel without making you sick.

Who is at risk of ESBL infection

ESBL-producing bacteria are not usually a risk to healthy people. But people in hospital are at risk of infection. This is because their body's defence mechanisms are weakened by illness and medical treatments.

Effects of ESBL-producing bacteria

ESBL-producing bacteria can cause infections like:

Treating ESBL infections

There are still a few antibiotics that can be used to treat infections caused by ESBL-producing bacteria. Your healthcare provider will decide which antibiotic will best treat your infection.

Staphylococcus aureus (commonly called staph, or staph aureus) is a type of bacteria. Staph is carried by many people on their skin and usually does not cause any problems.

If it does cause an infection, it can usually be treated with antibiotics. But one type of staph bacteria has become resistant to many antibiotics. This is called methicillin-resistant staphylococcus aureus (MRSA).

An infection caused by MRSA is more difficult to treat because there are fewer antibiotic options.

Who is at risk of MRSA infection

You are more likely to get this infection if you are in hospital or a long-term care facility. This is because illness and medical treatments can weaken the body's defence mechanisms. MRSA infection can easily spread in a hospital.

If you are being admitted to hospital, you may be screened for MRSA — especially if you have already been in hospital recently, or in a long term care facility. Screening involves hospital staff asking you questions to find out how likely it is that you are carrying MRSA. They may also take swabs to test for MRSA.

Effects of MRSA

MRSA can cause infections in your:

  • skin and other soft tissues
  • bones and joints
  • blood
  • heart
  • lungs, including pneumonia.

Treating MRSA

There are several things you should do if you have an MRSA infection, or you know you carry MRSA.

  • You may be given a course of antibiotics to take if your MRSA is causing an infection.
  • Cover all wounds, cuts, or sores with a plaster.
  • Before any examination or medical procedure, tell your healthcare provider. This is so they can take protective measures to reduce the spread of the bacteria.
  • If you get a new infection, tell your healthcare provider that you have had an MRSA infection. This is important because you may need different antibiotics to treat the infection.

Your healthcare provider may recommend trying to remove the MRSA from your skin. This process is called decolonisation treatment.

Skin decolonisation

Enterococci are generally harmless bacteria (germs) that live in the gut of most people.

Vancomycin is an antibiotic that is used to treat very serious infections. VRE is a type of enterococci bacteria that has become resistant to, and cannot be treated with, vancomycin.

Who is at risk of VRE infection

VRE is not usually a risk to healthy people.

If you are in hospital you are more at risk of infection as your normal body defence mechanisms may be weakened by:

  • illness
  • surgery or other procedures such as having a catheter (tube to drain fluids)
  • drugs.

Effects of VRE

VRE can cause:

Vancomycin antibiotics cannot be used to treat these infections.

Treating a VRE infection

Most VRE infections can be treated with an antibiotic that is not vancomycin. Your healthcare provider will arrange a blood test or take a swab to find out which antibiotic will best treat your infection.

Diagnosing antibiotic resistant infections

If your healthcare provider thinks you may carry or be infected with an antibiotic resistant bacteria, they will do some simple tests. These might involve:

  • a rectal swab
  • a poo (faecal) or wee (urine) sample
  • a skin, spit (saliva) or nasal swab
  • testing tissue from a wound
  • a blood test.

The results of these tests will help your healthcare provider work out the best form of treatment for you.

Avoiding the spread of antibiotic resistant infections

Avoiding infection at home

It is important you take precautions to prevent spreading bacteria to other people when you are at home.

  • wash your hands with soap and water and dry them thoroughly — especially after going to the toilet, before preparing and eating food and after touching animals
  • use your own towels and face cloths and do not share them with other people
  • avoid sharing grooming items such as nail scissors, tweezers, razors and toothbrushes
  • cover any skin wounds whenever possible
  • make sure you follow instructions and advice that your healthcare provider gives you on caring for wounds or managing medical devices.

You can still wash clothes, towels, utensils and dishes the way you usually wash them.

Avoiding infection in a hospital or a rest home

In hospital or rest home, you can potentially spread the bacteria to other patients or residents.

Staff will reduce the risk of spreading bacteria to others by:

  • regularly washing and drying their hands or using an alcohol‑based hand rub
  • isolating you in a single room with your own toilet facilities
  • wearing a gown and gloves if necessary.

You can help prevent spreading infection to other hospital patients or residents by:

  • regularly washing and drying your hands with soap and water or using an alcohol‑based hand rub
  • staying in your room unless you need to be transferred for special tests or treatment.

If you have an infection, you can have visitors, including pregnant women and young tamariki. But there may be a risk for visitors who have some long‑term health problems. If you are not sure it is safe for someone to visit, talk with your doctor or nurse.

It is important your visitors wash and dry their hands or use an alcohol‑based hand rub before and after visiting you. If they are visiting other patients in the hospital, they should visit you last.