Difficult-to-treat Escherichia coli bacteria, which often cause urinary tract infections, have become “widely prevalent” in communities in Europe and Canada, Johann Pitout and Kevin Laupland from the University of Calgary said in a review. The bacteria are likely being carried into hospitals, they said.

Public health institutions are already fighting MRSA, or meticillin-resistant Staphylococcus aureus, common bacteria that don’t respond to standard antibiotics. MRSA affects about 2 million Americans annually and costs some US$20 billion a year to treat, according to the U.S. Centers for Disease Control and Prevention. A 2006 report from the Infectious Diseases Society of America listed E. coli as one of the six drug-resistant microbes for which new medicines are “urgently needed.”

“Because of the increasing importance of multi-resistant E. coli in the community, clinicians should be aware of the potential of treatment failures associated with serious infections caused by these bacteria,” Pitout and Laupland said.

There have been reports of resistant bacteria from countries including the U.K., Spain, Italy, Greece and Canada, the researchers said. Though the bacteria commonly cause urinary tract infections, there have also been reports of bloodstream infections caused by resistant E. coli strains.

“These infections are currently rare, but it is possible that, in the near future, clinicians will be regularly confronted with hospital types of bacteria causing infections in patients from the community, a scenario very similar to that of community- acquired MRSA” the researchers said.

Drug-resistant germs such as MRSA have emerged because of overuse of standard treatments such as penicillin, oxacillin and amoxicillin, leading drugmakers to try to develop new antibiotics.

Carbapenems, a class of broad-spectrum antibiotic that includes Merck & Co.’s Invanz and AstraZeneca Plc’s Merrem, are now used to fight serious infections with this strain of bacteria. Increased use of this type of drug, sometimes doctors’ last line of defense against the infections, may make them ineffective, said the researchers, who have received previous research grants from Merck and AstraZeneca.

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