There is a clear correlation between the use of a particular type of antibiotic and the increased prevalence of a multi-resistant E. coli clone. This study illustrates the need for national surveillance systems to monitor antibiotic resistance.
Professor Jukka Corander and his colleagues have made an important breakthrough in our understanding of how the use of antibiotics can result in more dangerous and more resistant bacteria. Photo: Mona Mehus, University of Oslo
After analysing 5,000 E. coli infections in Norway and Great Britain during the period 2001-2017, the results leave us in no doubt.
In 2005, scientists showed for the very first time that the use of various antibiotics coincided with the occurrence of serious bacterial infections that were resistant to the same antibiotics. The report incorporated data from 26 European countries over a six-year period and attracted a lot of attention because it presented the hypothesis that use of antibiotics drives an increased prevalence of antibiotic-resistant bacteria in the population.
– Now, for the first time, we have been able to verify this hypothesis for one type of antibiotics often used to combat E. coli infections, explains professor Jukka Corander, who led the new study.
New and better technology
Technological developments, combined with data from two world-leading, national surveillance systems that monitor resistance in microbes, have provided scientists at the University of Oslo, UiT the Arctic University of Norway, the University of Cambridge and the Sanger Institute in Cambridge with the opportunity to carry out big-data analyses in order to investigate the causal relationship between the use of antibiotics and the occurrence of antibiotic resistance.
This time, the researchers generated to parallel sets of data derived from cases of blood poisoning with E. coli bacteria occurring over almost two decades: one set from England during the period 2001-2017 and one from Norway from 2002-2017.
– By comparing the results of the DNA analyses with the frequency of antibiotic use in the two countries, we were able for the first time to determine which types of antibiotics are particularly important for the growth of certain E. coli strains that are resistant to antibiotics.
Greater occurrence of infections in England
With the help of extensive data simulations, the scientists were able to investigate how different levels of the use of cephalosporin are related to how prevalent a bacterial strain is in the population.
– Our conclusion is that a more intensive use of the antibiotic cephalosporin in England than in Norway has resulted in a higher occurrence of infections caused by the multi-resistant E. coli strain ST131-C2 in British society.
Recommends national surveillance systems
The study shows how important national surveillance systems are for combatting antibiotic resistance. With the help of analyses of representative data drawn from a number of years, it is possible to draw clear conclusions about which factors have a bearing on the development of antibiotic resistance.
Collaboration of scientists from many countries
Scientists contributing to the study included researchers from the University of Oslo, UiT the Arctic University of Norway; Turku University Hospital Finland, Ninewells Hospital and Medical School in Scotland, the University Hospital of North Norway, Imperial College London, the University of Birmingham and the University of Cambridge.
How the study was funded
The research was funded by the Norwegian Trond Mohn Foundation via the AMR BATTALION project, Marie Sklodowska-Curie Actions and the European Research Council (ERC). The genome sequencing was carried out at the Wellcome Sanger Institute in Great Britain.
Contact information
Scientific references from 2023 and 2005
Outpatient antibiotic use in Europe and association with resistance: a cross-national database study
