MRSA drug cure hope

Gel inside nose could provide breakthrough against MRSA

Monday, May 19, 2008

By Jane Merrick and Brian Brady

A simple procedure of placing a gel inside the nose could hold the key to eradicating the superbug responsible for the deaths of more than 1,600 patients in the UK every year.

A British research firm yesterday claimed that their discovery represented a "major breakthrough" in the battle against MRSA. The firm, Destiny Pharma, is already carrying out human trials on the drug.

The compound, codenamed XF-73, destroys the five most common strains of methicillin-resistant Staphylococcus aureus bacteria in laboratory tests in a peer-reviewed study. It works in a different way from antibiotics, which are becoming increasingly ineffective, as MRSA builds up resistance to them.

News of the development comes amid renewed controversy over poor standards of cleanliness in hospitals. Yesterday, the parents of a 17-year-old girl said they would sue the "filthy" hospital where she died after contracting the superbug. Samantha Fallon was put on an "overcrowded" general ward at the University Hospital of North Staffordshire, where she was being treated for a virus, said Keith and Sue Fallon.

And this week the Government's infections adviser will warn that overprescription of antibiotics by hospitals is causing a rise in superbugs, including MRSA and Clostridium difficile. Professor Mark Wilcox of Leeds University said overuse of antibiotics has led to the increasing resistance of MRSA and C. diff to the drugs.

The new drug, developed by Destiny Pharma, could be crucial in saving lives because MRSA has shown no resistance to it, even after 55 repeat exposures. By 2011, XF-73 could be used to prevent the spread of infection in hospital wards, say researchers. Within six years, they claim, it could routinely cure patients already infected with MRSA.

However, the drug would need to be approved by the National Institute for Clinical Excellence (Nice) as it would be likely to cost the NHS millions of pounds. Continuing human trials mean there is a risk that XF-73 could follow other promised treatments that have bitten the dust.

New figures obtained by The Independent on Sunday show that more than a third of new-generation hospitals have failed to meet strict targets for reducing MRSA rates on their wards.

Some 35 out of 83 foundation hospitals admit they have had more cases than expected up to the end of December, despite being ordered by the Government to undertake a "deep clean".

The Health minister, Lord Darzi, who is conducting a review of the NHS, has suggested there should be MRSA-screening of patients undergoing elective surgery to prevent its taking hold in hospitals. While MRSA infection rates have stabilised in the past two years, deaths from C. diff are three times the rate of MRSA and rising.

The new compound works on such bacteria by sticking to them through " electrostatic binding", destroying the cell membrane. Many antibiotics used against MRSA are "bacteriostatic" – which means they merely prevent the growth of bacteria, rather than killing them.

Five of the most common strains of MRSA were tested against the drug. A topical antibiotic was used as a control.

Both XF-73 and the antibiotic were separately exposed to the strains of MRSA 55 times, over as many days. Each time 99 per cent of the bacteria were destroyed, leaving the strongest 1 per cent to survive.

This was allowed to grow again before being exposed to the XF-73 and the control antibiotic. The scientists then measured how much of the drug was needed to kill the same amount of bacteria for each exposure.

Dr Bill Love, chief executive of Destiny Pharma, said XF-73 was crucial in fighting MRSA and could be used against C. diff at some stage.

It would also be more effective than deep-cleaning, because the drug would destroy MRSA carried on and transferred between people, he said. "If it goes through clinical trials successfully, it really is a completely fundamental breakthrough. The potential is really quite amazing.

"We know that bacteria can very rapidly develop resistance to traditional antibiotics. This is the reason why there is a healthcare crisis at the moment."

The work by the Brighton firm was unveiled at the annual European Conference of Clinical Microbiology and Infectious Diseases in Barcelona last month.

In human trials, the compound is contained in a tiny amount of gel placed inside the nostril. This would prevent the spread of MRSA in hospitals and in the community. Dr Love said tablet and injection forms of XF-73 could be in use within a few years. He hoped NHS strategic health authorities would be willing to pay for XF-73 if it was approved by Nice, adding: "In terms of impact, it would actually save hospitals money. So it is a no-brainer."

Derek Butler, of the campaign group MRSA Action, welcomed the development. But he said the advance could have been made much earlier if the Government had ploughed more resources into the efforts to reduce infections.

A Department of Health spokesperson said: "This is interesting research, and we maintain a close watch on these and other emerging findings in the field.

"Reducing healthcare-associated infections is a top priority for the NHS, and we are already seeing significant reductions in healthcare-associated MRSA bloodstream infections, with rates down by 30 per cent compared with the same period last year," he said.

'Five years later I'm still in constant pain'

James Wollacott was 19 years old when he damaged his knee ligaments. A keen roller-hockey player, he thought everything would be fine when surgeons at St Mary's Hospital, London, repaired the damage in May 2003. But the wound became infected and when MRSA took hold he nearly lost his life. Five years and several operations later, Mr Wollacott cannot walk any great distance and is in constant pain. He has had to abandon plans to become an electrician. Still fighting for compensation, Mr Wollacott says his life has been ruined: "From the knee down I get excruciating pain. I had always been active and that's what's killing me now – not being able to play sports or run around. I've done nothing for five years. It's driving me crazy. I'm watching my mates play sport and I'm sitting here letting the world go by."

Jonathan Owen

Superbugs

28 October 2007

Scientists discover a naturally occurring weapon against potentially deadly hospital infections such as MRSA.

30 March 2008

With a screening programme postponed, thousands of patients are still at risk from superbugs, despite a £57m "deep clean" of hospitals.

6 April 2008

Hospital trusts are allowing doctors and nurses who have tested positive for MRSA and other infections to continue treating patients.

What they say

"This is exciting and shows the possibility of innovation to find new means to fight MRSA"

Andrew Lansley, Shadow health secretary

"The Government knows the sire of this problem, but is not doing enough to tackle it"

Derek Butler, Spokesman for MRSA Action

"This is a completely fundamental breakthrough. The potential is quite amazing"

Dr Bill Love, Chief executive, Destiny Pharma