Lyme disease in the U.S. is caused by a form of bacteria, the spirochete Borrelia burgdorferi, infecting humans by tick bites. It typically begins with a bull's-eye skin rash, accompanied by fever, muscle aches, or other flu-like symptoms. If diagnosed early, Lyme can be treated successfully within a month with either oral or intravenous antibiotics. Nearly 60 percent of patients who do not receive antibiotic therapy early in the illness develop intermittent or persistent arthritis, particularly affecting the knees. Moreover, a small percentage of Lyme patients who do receive antibiotic therapy suffer from persistent arthritis for months or even several years after 2-3 months of oral and intravenous antibiotic therapy. This confounding condition has been termed antibiotic-refractory, or slowly resolving, Lyme arthritis.
To gain insights into the survival of spirochetes following antibiotic therapy, researchers at the Center for Immunology and Inflammatory Diseases at Massachusetts General Hospital, Harvard Medical School, and the National Center for Infectious Diseases at the Centers for Disease Control and Prevention teamed up to study antibody responses to Borrelia burgdorferi in patients with antibiotic-refractory or antibiotic-responsive Lyme arthritis. Presented in the December 2007 issue of Arthritis & Rheumatism , their findings indicate that joint inflammation persists in patients with antibiotic-refractory Lyme arthritis after the disease-spreading spirochetes have been killed.
To compare antibody responses and determine their effect on Lyme arthritis, the team tested at least 3 blood serum samples each from 41 patients with antibiotic-refractory arthritis, 23 patients with antibiotic-responsive arthritis, and 10 non-antibiotic-treated controls - arthritis patients who had contracted Lyme disease during the late 1970s before the cause of the disease was known. Samples were obtained during the period of arthritis and sometimes after several months of remission for all patient groups. The patients with antibiotic-refractory and antibiotic-responsive arthritis had a similar age range, sex distribution, and duration of arthritis prior to antibiotic therapy.
All samples were tested for IgG reactivity with Borrelia burgdorferi bacteria and 4 outer surface lipoproteins of the spirochete. Among non-antibiotic-treated patients, antibody titers to Borrelia burgdorferi remained high throughout a prolonged period of persistent arthritis, 2 to 5 years. In contrast, in patients with antibiotic-responsive arthritis, the level of antibody titers to Borrelia burgdorferi and most outer-surface proteins remained steady or decreased within the first 3 months of starting antibiotic therapy. Consistent with this finding, these patients usually experienced relief from joint swelling during a 1-month course of oral antibiotics. In patients afflicted with antibiotic-refractory arthritis, the level of antibody titers to Borrelia burgdorferi and most outer-surface antigens increased slightly during the first 1 to 3 months of treatment. These patients suffered from persistent joint swelling for a median duration of 10 months, despite 2 to 3 months of oral or intravenous antibiotics. However, by 4 to 6 months after starting antibiotic therapy, antibody titers declined to similar levels in both antibiotic-treated groups, regardless of their differences in arthritis symptoms.
"In Lyme disease, there is a great need for a test that could be used in clinical practice as a marker for spirochetal eradication," observes Dr. Allen C. Steere, the senior author of the study. Yet, as he acknowledges, ridding the body of the Borrelia burgdorferi bacteria and its surface antigens does not always bring relief from arthritis. "Increasing antibody titers in patients usually suggested the presence of live spirochetes, whereas declining titers suggested that they had been killed," he notes. "Thus, patients with Lyme arthritis who have a sustained, gradual decline in antibody reactivity probably have the nearly complete or total eradication of spirochetes from the joint as a result of antibiotic therapy, even if joint inflammation persists after the period of infection."
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Article adapted by Medical News Today from original press release.
----------------------------
Article: "Antibody Responses to Borrelia burgdorferi in Patients With Antiobiotic-Refractory, Antibiotic-Responsive, or Non-Antibiotic-Treated Lyme Disease," Priya Kannian, Gail McHugh, Barbara J.B. Johnson, Rendi M. Bacon, Lisa J. Glickstein, and Allen C. Steere, Arthritis & Rheumatism, December 2007.
Source: Amy Molnar
Wiley-Blackwell
Friday, December 14, 2007
Thursday, December 13, 2007
Be vigilant against staph
WITH ABOUT 19,000 people dying nationwide each year from antibiotic-resistant staph infections, it's important to be vigilant in personal hygiene, public health surveillance and aggressive countermeasures at a level consistent with the fight against AIDS infections.
Indeed, more people die in the United States each year from staph infections than from AIDS.
Local officials confronted the deadly bacteria recently in Spanish Fort, when a high school football player developed an infection. To their credit, school officials called in a professional cleaning crew to disinfect school buildings.
Fortunately, the Spanish Fort student recovered, but others who have contracted staph weren't so lucky. A Valley, Ala., woman died in October of complications from MRSA (methicillin-resistant Staphylococcus aureus) infection, becoming the first MRSA victim in Alabama.
It's estimated that 90,000 people have MRSA in the United States at any one time, though most of the cases occur in hospitals where health care professionals take aggressive measures against any infection.
Staph bacteria, though, are often present on the skin and in nasal passages. The "super bug" drug-resistant bacteria live among easily treatable bacteria and can enter a person's bloodstream through a minor scrape or cut, or through the skin pores.
Moreover, the dangerous bacteria can live on towels and other items that have come in contact with skin, jumping onto new hosts who come in contact with them, spreading and leading to an outbreak (defined as three or more cases).
Ironically, these super bugs occur because of the medical community's aggressive use of antibiotics against normal bacteria. Because of this widespread use, some bacteria become resistant to drugs.
But staph infections can be prevented, which is where personal hygiene comes in. Health officials suggest frequent washing of hands, showering after exercise, avoiding using someone else's towel, razor or other personal items that come in contact with skin, and cleansing of exercise equipment in public gyms.
Public health officials, too, can do more by requiring more aggressive reporting of individual cases, especially those that develop outside hospitals. With public awareness, personal hygiene and public health watchfulness, outbreaks of MRSA from community sources can become a health problem of the past.
© 2007 Press-Register. All rights reserved.
Indeed, more people die in the United States each year from staph infections than from AIDS.
Local officials confronted the deadly bacteria recently in Spanish Fort, when a high school football player developed an infection. To their credit, school officials called in a professional cleaning crew to disinfect school buildings.
Fortunately, the Spanish Fort student recovered, but others who have contracted staph weren't so lucky. A Valley, Ala., woman died in October of complications from MRSA (methicillin-resistant Staphylococcus aureus) infection, becoming the first MRSA victim in Alabama.
It's estimated that 90,000 people have MRSA in the United States at any one time, though most of the cases occur in hospitals where health care professionals take aggressive measures against any infection.
Staph bacteria, though, are often present on the skin and in nasal passages. The "super bug" drug-resistant bacteria live among easily treatable bacteria and can enter a person's bloodstream through a minor scrape or cut, or through the skin pores.
Moreover, the dangerous bacteria can live on towels and other items that have come in contact with skin, jumping onto new hosts who come in contact with them, spreading and leading to an outbreak (defined as three or more cases).
Ironically, these super bugs occur because of the medical community's aggressive use of antibiotics against normal bacteria. Because of this widespread use, some bacteria become resistant to drugs.
But staph infections can be prevented, which is where personal hygiene comes in. Health officials suggest frequent washing of hands, showering after exercise, avoiding using someone else's towel, razor or other personal items that come in contact with skin, and cleansing of exercise equipment in public gyms.
Public health officials, too, can do more by requiring more aggressive reporting of individual cases, especially those that develop outside hospitals. With public awareness, personal hygiene and public health watchfulness, outbreaks of MRSA from community sources can become a health problem of the past.
© 2007 Press-Register. All rights reserved.
MRSA case in Mattawan HS
MATTAWAN (NEWSCHANNEL 3) - A student at Mattawan High School has been diagnosed with MRSA.
Methicillin-resistant Staphylococcus aureus or MRSA is one of the "superbugs" that have evolved resistance to some commonly used antibiotics.
The Superintendent has told Newschannel 3 that the school has not been closed and the Health Department does not consider it a serious case.
The Superintendent also says that the school district is following cleaning and disinfecting procedures outlined by the Health Department.
The condition of the student with the infection is not known.
Methicillin-resistant Staphylococcus aureus or MRSA is one of the "superbugs" that have evolved resistance to some commonly used antibiotics.
The Superintendent has told Newschannel 3 that the school has not been closed and the Health Department does not consider it a serious case.
The Superintendent also says that the school district is following cleaning and disinfecting procedures outlined by the Health Department.
The condition of the student with the infection is not known.
Deodoriser may help beat superbugs in hospitals
By Simon Bristow
A MACHINE used to rid hospitals of bad smells could help beat so-called superbugs.
Wigan-based firm Scent Technologies has discovered that its ST-PRO deodorising machine not only issues a pleasant aroma, but proves highly effective in killing airborne bacteria associated with MRSA and Clostridium difficile.
The discovery was made almost by chance at a hospital in Whiston, St Helens, three years ago. And following seven months of clinical trials in the burns unit at Wythenshawe Hospital, Manchester, the product is to be developed and produced by Hull company Bonus Electrical.
Prof Valerie Edwards-Jones, a microbiologist at Manchester Metropolitan University, said: "We found in the burns unit that it reduced airborne counts by 90 per cent. What surprised us was in the control room, where we didn't have any vapours, the counts were down there."
He said the results were "very encouraging."
The machine, which has also been trialled at Airedale Hospital, works by releasing an invisible vapour containing essential oils into the air.
Scent Technologies director Roy Jackson said the machine could also be used in offices and adapted for use in aircraft.
A MACHINE used to rid hospitals of bad smells could help beat so-called superbugs.
Wigan-based firm Scent Technologies has discovered that its ST-PRO deodorising machine not only issues a pleasant aroma, but proves highly effective in killing airborne bacteria associated with MRSA and Clostridium difficile.
The discovery was made almost by chance at a hospital in Whiston, St Helens, three years ago. And following seven months of clinical trials in the burns unit at Wythenshawe Hospital, Manchester, the product is to be developed and produced by Hull company Bonus Electrical.
Prof Valerie Edwards-Jones, a microbiologist at Manchester Metropolitan University, said: "We found in the burns unit that it reduced airborne counts by 90 per cent. What surprised us was in the control room, where we didn't have any vapours, the counts were down there."
He said the results were "very encouraging."
The machine, which has also been trialled at Airedale Hospital, works by releasing an invisible vapour containing essential oils into the air.
Scent Technologies director Roy Jackson said the machine could also be used in offices and adapted for use in aircraft.
Glaxo boosts pipeline with two new biotech deals
By Ben Hirschler
LONDON (Reuters) - GlaxoSmithKline , Europe's biggest drugmaker, continued its recent rapid pace of deal-making on Monday by signing two new early-stage biotech alliances in cancer and anti-infective medicine.
The deals with privately owned U.S. cancer specialist OncoMed Pharmaceuticals and Belgium's Galapagos NV involve limited upfront investment. But Glaxo could make multibillion-dollar milestone payments if the products succeed.
Glaxo, like many large drugmakers, is hungry to find promising new drugs from outside its own laboratories and has stepped up its external collaboration efforts in the past year.
Further deals could be forthcoming as the year-end approaches, some analysts say.
Under the alliance with OncoMed, worth up to $1.4 billion (684 million pounds) or more, Glaxo has secured access to the Californian company's novel antibodies that target cancer stem cells.
Cancer stem cells are believed to play a key role in the establishment, metastasis -- or spread -- and recurrence of cancer.
The collaboration gives Glaxo an option to license four product candidates from OncoMed's library of monoclonal antibodies and increases its growing presence in oncology, the two companies said in a joint statement.
OncoMed will receive an undisclosed initial cash payment as well as an equity investment. In addition, it is eligible to earn milestone payments up to $1.4 billion from Glaxo, if certain clinical projects are commercially successful.
OncoMed will also get double-digit percentage royalties on eventual product sales, while Glaxo will have an option to invest in a future OncoMed initial public offering.
GALAPAGOS ALLIANCE
Separately, Glaxo has struck an alliance with Galapagos to discover and develop new anti-infective medicines against up to six targets based on Galapagos's natural product drug-delivery platform.
Galapagos will receive up to 3.5 million euros (2.51 million pounds) in technology access fees and up to 215 million euros ($315.1 million) in total payments for each marketed product.
Galapagos will be responsible for the discovery and development of natural product small molecule drug candidates through to "proof of concept" in clinical trials, at which point GSK will have exclusive option to license each compound for further development and commercialisation on a worldwide basis.
Shares in Galapgos were 3.4 percent higher by 2:34 p.m., while Glaxo was 0.8 percent lower in a slightly weaker European pharmaceuticals sector <.SXDP>.
The move reflects Glaxo's decision to place more emphasis on developing new antibiotics and anti-virals, after announcing in February it was setting up a new drug-discovery unit devoted to infectious diseases.
Other recent Glaxo licensing deals include an October agreement with Synta Pharmaceuticals Corp for rights to its experimental skin cancer drug, which could eventually earn the U.S. firm more than $1 billion, and a potential $1.5 billion brain drug deal with Targacept Inc in July.
In November, Glaxo agreed to buy privately held heart drug specialist Reliant Pharmaceuticals for $1.65 billion.
(Editing by Louise Ireland)
(c) Reuters 2007. All rights reserved.
LONDON (Reuters) - GlaxoSmithKline , Europe's biggest drugmaker, continued its recent rapid pace of deal-making on Monday by signing two new early-stage biotech alliances in cancer and anti-infective medicine.
The deals with privately owned U.S. cancer specialist OncoMed Pharmaceuticals and Belgium's Galapagos NV involve limited upfront investment. But Glaxo could make multibillion-dollar milestone payments if the products succeed.
Glaxo, like many large drugmakers, is hungry to find promising new drugs from outside its own laboratories and has stepped up its external collaboration efforts in the past year.
Further deals could be forthcoming as the year-end approaches, some analysts say.
Under the alliance with OncoMed, worth up to $1.4 billion (684 million pounds) or more, Glaxo has secured access to the Californian company's novel antibodies that target cancer stem cells.
Cancer stem cells are believed to play a key role in the establishment, metastasis -- or spread -- and recurrence of cancer.
The collaboration gives Glaxo an option to license four product candidates from OncoMed's library of monoclonal antibodies and increases its growing presence in oncology, the two companies said in a joint statement.
OncoMed will receive an undisclosed initial cash payment as well as an equity investment. In addition, it is eligible to earn milestone payments up to $1.4 billion from Glaxo, if certain clinical projects are commercially successful.
OncoMed will also get double-digit percentage royalties on eventual product sales, while Glaxo will have an option to invest in a future OncoMed initial public offering.
GALAPAGOS ALLIANCE
Separately, Glaxo has struck an alliance with Galapagos to discover and develop new anti-infective medicines against up to six targets based on Galapagos's natural product drug-delivery platform.
Galapagos will receive up to 3.5 million euros (2.51 million pounds) in technology access fees and up to 215 million euros ($315.1 million) in total payments for each marketed product.
Galapagos will be responsible for the discovery and development of natural product small molecule drug candidates through to "proof of concept" in clinical trials, at which point GSK will have exclusive option to license each compound for further development and commercialisation on a worldwide basis.
Shares in Galapgos were 3.4 percent higher by 2:34 p.m., while Glaxo was 0.8 percent lower in a slightly weaker European pharmaceuticals sector <.SXDP>.
The move reflects Glaxo's decision to place more emphasis on developing new antibiotics and anti-virals, after announcing in February it was setting up a new drug-discovery unit devoted to infectious diseases.
Other recent Glaxo licensing deals include an October agreement with Synta Pharmaceuticals Corp for rights to its experimental skin cancer drug, which could eventually earn the U.S. firm more than $1 billion, and a potential $1.5 billion brain drug deal with Targacept Inc in July.
In November, Glaxo agreed to buy privately held heart drug specialist Reliant Pharmaceuticals for $1.65 billion.
(Editing by Louise Ireland)
(c) Reuters 2007. All rights reserved.
TROOPS BRING BUG TO CANADA
Hospitals Warned; Drug-resistant bacterium coming from Afghanistan
Tom Blackwell, National Post
Published: Thursday, December 13, 2007
Federal authorities are warning hospitals across the country to beware a highly drug-resistant bacterium that wounded troops are bringing back from Afghanistan -- and which could inadvertently be spread to civilian patients.
The threat posed by the resistant strain of acinetobacter underlines the health care system's general lack of readiness for such emerging infections as they arrive in the country, said a senior Public Health Agency of Canada official.
Several soldiers being treated in civilian hospitals here have already developed pneumonia from the drug-resistant strain of the bacterium, which scientists say likely originated in the Canadian-led trauma centre at Kandahar Air Field.
Hospitals are being advised by the agency to screen injured soldiers for the bug, and take infection-control precautions if they test positive.
No transmission to nonmilitary patients has yet been detected, and the bug is not seen as much of a danger to healthy people outside of hospital. The fear, however, is that the resistant strain could genetically combine with more easily treatable versions of the bacterium that are more common in Canadian intensive-care units, said Shirley Paton of the public health agency.
"We're seeing a new organism being introduced into the Canadian swamp of organisms, this one being highly resistant," she said. "If we get someone with this highly resistant strain, are the two bugs going to get together into one? ... We're quite concerned that this will start spreading and become the acinetobacter of choice in the ICUs. We're really worried about that kind of transmission."
Outbreaks that may have originated in soldiers coming from Iraq or Afghanistan have already occurred in U.S. and British hospitals.
It is "critical" that hospital infection-control officers here are aware of the issue and respond appropriately, says a recent article in the Canadian Journal of Infection Control by agency officials and outside experts.
"Ultimately, there is the risk that you end up with a brand of organism that is invulnerable to antibiotics. There is little treatment available," said Dr. Andrew Simor of Toronto's Sunnybrook Health Sciences Centre, one of the country's leading infectious-disease experts. "We have to take that seriously."
The public health agency is planning a meeting for February or March involving the Department of National Defence, provincial public health departments and major hospitals to discuss the acinetobacter problem, and newly emerged pathogens generally, Ms. Paton said.
"How do we respond to something that is just arriving? Can we track it, can we stop it? Can we hold it?" she asked. "I don't think we have the processes in place yet to really respond in a nice, efficient, everybody-knows-what-they're-doing kind of manner."
Drug-resistant microbes, sometimes called superbugs, have become an increasing cause for anxiety in Canadian hospitals, with the most common of them, Methicillin-resistant staphylococcus aureus (MRSA) being blamed for thousands of deaths a year.
Often found in soil, acinetobacter is a danger to the old and seriously ill, particularly those on breathing machines, causing wound and blood infections and pneumonia. It was detected in many American casualties of the Vietnam war, then arose again in 2003 when U.S. and British
doctors started finding it in soldiers returning injured from Iraq and Afghanistan. At least four U.S. troops have died from the infection since then.
Canadian soldiers started testing positive for the bug after their mission in southern Afghanistan began last year. The most seriously wounded are sent to civilian hospitals here for further treatment.
At least 10 with acinetobacter have shown up in ICUs, Ms. Paton said. There have been an unknown number of other "walking wounded" troops with the bug, who have not been admitted to hospitals but might have visited family physicians or military doctors, she said.
A paper published in the journal BMC Infectious Diseases in August documents the cases of four Canadian soldiers, injured by roadside bombs and other means, who ended up on ventilators in 2006. All developed a pneumonia caused by acinetobacter that was resistant even to the carbapenem class of antibiotics, virtually the last line of defence against the microbe.
Although the paper does not mention the outcomes of their cases, Dr. Simor, a co-author of the paper, said he is unaware of any deaths from acinetobacter infection of Canadian combatants.
An investigation by the Defence Department found an identical strain of the bacteria in a ventilator used at the Canadian-managed trauma hospital on Kandahar Air Field, a NATO base, suggesting that is where it originated. Measures have since been taken to try to clear the field hospital of acinetobacter, Dr. Simor said.
Meanwhile, the Forces' health services department has advised families of some returning soldiers to avoid unprotected contact with the soldier until he or she has been screened for acinetobacter, according to an article by three military doctors in a recent issue of Wound Care Canada.
Tom Blackwell, National Post
Published: Thursday, December 13, 2007
Federal authorities are warning hospitals across the country to beware a highly drug-resistant bacterium that wounded troops are bringing back from Afghanistan -- and which could inadvertently be spread to civilian patients.
The threat posed by the resistant strain of acinetobacter underlines the health care system's general lack of readiness for such emerging infections as they arrive in the country, said a senior Public Health Agency of Canada official.
Several soldiers being treated in civilian hospitals here have already developed pneumonia from the drug-resistant strain of the bacterium, which scientists say likely originated in the Canadian-led trauma centre at Kandahar Air Field.
Hospitals are being advised by the agency to screen injured soldiers for the bug, and take infection-control precautions if they test positive.
No transmission to nonmilitary patients has yet been detected, and the bug is not seen as much of a danger to healthy people outside of hospital. The fear, however, is that the resistant strain could genetically combine with more easily treatable versions of the bacterium that are more common in Canadian intensive-care units, said Shirley Paton of the public health agency.
"We're seeing a new organism being introduced into the Canadian swamp of organisms, this one being highly resistant," she said. "If we get someone with this highly resistant strain, are the two bugs going to get together into one? ... We're quite concerned that this will start spreading and become the acinetobacter of choice in the ICUs. We're really worried about that kind of transmission."
Outbreaks that may have originated in soldiers coming from Iraq or Afghanistan have already occurred in U.S. and British hospitals.
It is "critical" that hospital infection-control officers here are aware of the issue and respond appropriately, says a recent article in the Canadian Journal of Infection Control by agency officials and outside experts.
"Ultimately, there is the risk that you end up with a brand of organism that is invulnerable to antibiotics. There is little treatment available," said Dr. Andrew Simor of Toronto's Sunnybrook Health Sciences Centre, one of the country's leading infectious-disease experts. "We have to take that seriously."
The public health agency is planning a meeting for February or March involving the Department of National Defence, provincial public health departments and major hospitals to discuss the acinetobacter problem, and newly emerged pathogens generally, Ms. Paton said.
"How do we respond to something that is just arriving? Can we track it, can we stop it? Can we hold it?" she asked. "I don't think we have the processes in place yet to really respond in a nice, efficient, everybody-knows-what-they're-doing kind of manner."
Drug-resistant microbes, sometimes called superbugs, have become an increasing cause for anxiety in Canadian hospitals, with the most common of them, Methicillin-resistant staphylococcus aureus (MRSA) being blamed for thousands of deaths a year.
Often found in soil, acinetobacter is a danger to the old and seriously ill, particularly those on breathing machines, causing wound and blood infections and pneumonia. It was detected in many American casualties of the Vietnam war, then arose again in 2003 when U.S. and British
doctors started finding it in soldiers returning injured from Iraq and Afghanistan. At least four U.S. troops have died from the infection since then.
Canadian soldiers started testing positive for the bug after their mission in southern Afghanistan began last year. The most seriously wounded are sent to civilian hospitals here for further treatment.
At least 10 with acinetobacter have shown up in ICUs, Ms. Paton said. There have been an unknown number of other "walking wounded" troops with the bug, who have not been admitted to hospitals but might have visited family physicians or military doctors, she said.
A paper published in the journal BMC Infectious Diseases in August documents the cases of four Canadian soldiers, injured by roadside bombs and other means, who ended up on ventilators in 2006. All developed a pneumonia caused by acinetobacter that was resistant even to the carbapenem class of antibiotics, virtually the last line of defence against the microbe.
Although the paper does not mention the outcomes of their cases, Dr. Simor, a co-author of the paper, said he is unaware of any deaths from acinetobacter infection of Canadian combatants.
An investigation by the Defence Department found an identical strain of the bacteria in a ventilator used at the Canadian-managed trauma hospital on Kandahar Air Field, a NATO base, suggesting that is where it originated. Measures have since been taken to try to clear the field hospital of acinetobacter, Dr. Simor said.
Meanwhile, the Forces' health services department has advised families of some returning soldiers to avoid unprotected contact with the soldier until he or she has been screened for acinetobacter, according to an article by three military doctors in a recent issue of Wound Care Canada.
Hospital 'dealing with' super bug
SERVICES at a major Brisbane hospital with an outbreak of a "super bug" will not be disrupted despite two wards being closed, its clinical chief says.
The Royal Brisbane and Women's Hospital clinical chief executive officer, Professor Keith McNeil, said staff were working to eradicate vancomycin resistant enterococcus (VRE), which is resistant to antibiotics.
On Friday, the hospital closed two 30-bed wards to new admissions when 21 patients tested positive to the bug, caused by an enterococcus bacteria which normally lives safely in the bowel.
The medical wards are being disinfected and patients are being screened as they leave.
Prof McNeil said staff had been put on extra shifts to carry out the "labour-intensive" cleaning, but said hospital was not under unusual strain.
"Bed pressures are ever present every day," he said.
"We run a balance between the number of people that are coming in and the number of people who (we) are able to discharge, so we have to put in strategies to try and maintain that throughput of patients.
"At this point in time we are not having any difficulties."
Most patients who tested positive to the bug were not sick, Prof McNeil said.
However, people with low immunity - including those with chronic disease, organ transplant recipients, diabetics and elderly people - can suffer severe infection, which is difficult to treat because of the bug's resistance.
Prof McNeil said some patients receiving dialysis had tested positive but had not come down with "overwhelming illness" as yet.
He said dealing with super bugs was now part of the day-to-day management of all hospitals.
"That's part of being a big teaching hospital," he said.
"We're not unique in this - this happens all around Australia and all around the developed world."
The Royal Brisbane and Women's Hospital clinical chief executive officer, Professor Keith McNeil, said staff were working to eradicate vancomycin resistant enterococcus (VRE), which is resistant to antibiotics.
On Friday, the hospital closed two 30-bed wards to new admissions when 21 patients tested positive to the bug, caused by an enterococcus bacteria which normally lives safely in the bowel.
The medical wards are being disinfected and patients are being screened as they leave.
Prof McNeil said staff had been put on extra shifts to carry out the "labour-intensive" cleaning, but said hospital was not under unusual strain.
"Bed pressures are ever present every day," he said.
"We run a balance between the number of people that are coming in and the number of people who (we) are able to discharge, so we have to put in strategies to try and maintain that throughput of patients.
"At this point in time we are not having any difficulties."
Most patients who tested positive to the bug were not sick, Prof McNeil said.
However, people with low immunity - including those with chronic disease, organ transplant recipients, diabetics and elderly people - can suffer severe infection, which is difficult to treat because of the bug's resistance.
Prof McNeil said some patients receiving dialysis had tested positive but had not come down with "overwhelming illness" as yet.
He said dealing with super bugs was now part of the day-to-day management of all hospitals.
"That's part of being a big teaching hospital," he said.
"We're not unique in this - this happens all around Australia and all around the developed world."
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