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Antibiotic-resistant Germs Flourish in Hospitals

From info@clari.net Mon Nov 20 15:28:05 PST 1995
Subject: Antibiotic Abuse Spawns Bugs
Organization: Copyright 1995 by The Associated Press

Ordinary infections that used to be cured with penicillin or similar drugs now cause serious illness, particularly among patients in hospitals, where bacteria flourish, and among those with weak immune systems.

``The ultimate drug-eating everything-resistant monster superbug has been created, and is beginning to live and breed in hospitals now,'' writes Geoffrey Cannon in ``Superbug Nature's Revenge: Why Antibiotics Can Breed Disease.'' The book foresees a doomsday scenario should doctors and patients continue their pill-popping binge.

Cannon, a former journalist and author of several books on health, is director of science for the World Cancer Research Fund, a fund-raising organization in London.

``Will the problem get exponentially worse? Certainly,'' Cannon said in an interview. ``Does that mean new epidemics of drug resistant infections? Certainly. That's what's happening now. Will some of these (infections) be deadly ? Certainly. It's possible that an epidemic of drug-resistant bacteria could lead to an epidemic like AIDS.''

Infectious disease experts interviewed agreed that Cannon's forecast, though grim, is realistic.

The American Society for Microbiology has called drug resistance a public health emergency.

The U.S. Centers for Disease Control and Prevention recently issued guidelines urging hospitals and doctors to use antibiotics more sparingly to slow the development of drug-resistant strains of germs.

Dr. Frank Bia, professor of infectious diseases at Yale University, says ``it's like traveling into the Jurassic Park of microbiology when you travel into the ICU (intensive care unit) because you are dealing with these wild strains that are hard to treat.''

It's a microbe's version of Darwin's survival-of-the-fittest theory. Drugs kill vulnerable strains of germs, but the tough survive and flourish.

The discovery of antibiotics in the first half of the century was considered a triumph of man against microbe. The good pills would wipe out bad germs for good. Enthusiasts predicted a world free of infectious disease. However, the reality is quite different.

Already, bacteria that cause pneumonia, dysentery or ear infections are resistant to ordinary antibiotics. Some hospitals cannot treat enterococci that can infect kidneys, bladders, wounds and blood.

Some 13,300 Americans died in 1992 from infections that were no longer sensitive to antibiotics, according to a CDC study cited in Cannon's book.

Every year, Cannon writes, 60,000 to 70,000 people die from hospital infections, half of which are caused by ``drug-resistant superbugs.''

In the 1970s, a shot of penicillin destroyed Neisseria gonorrhoea, a common sexually transmitted disease. Now, according to the World Health Organization, penicillin is useless against gonorrhea in the Philippines, where all the strains are drug-resistant. In Hong Kong, according to the WHO, 77.9 percent of gonorrhea cases are penicillin-resistant.

In South Africa, the WHO estimates that 40 percent of community-acquired streptococcal infections and 95 percent of hospital-acquired strep are resistant to penicillin.

And in Britain, about two-thirds of staphylococcus infections that can cause pneumonia and infect skin and wounds resist most ordinary antibiotics.

For so-called multi-drug-resistant strains of bacteria, the drug of last resort has been vancomycin, a costly alternative. Recently, however, vancomycin-resistant strains have emerged, Bia said.

Resistance is rampant among the germs that cause tuberculosis, malaria, cholera and typhoid, primarily because of misuse and overuse of therapy.

``Resistance is manmade and usually if drug resistance occurs it's the results of medical malpractice,'' said Dr. Paul Nunn, chief of research for WHO's Global Tuberculosis Program in Geneva.

Experts blame patients for urging their doctors to give them medicine, doctors for misusing the drugs, and drug-makers for pushing their products.

It is easier for doctors to prescribe a pill that wipes out a host of germs than do tests and prescribe the one drug for that specific infection.

Often, patients infected with viruses are treated with antibiotics. But antibiotics destroy bacteria, not viruses.

Bacteria have a few strategies to escape drugs: Some spew chemicals that inactivate the drugs. Others rearrange their outer wall so drugs cannot penetrate.

Bacteria share their trade secrets by passing genetic information that holds the key to drug resistance among each other. These packets of vital information, called plasmids, are easily passed among bacteria of different species. That's why hospitals, with an array of germs in close quarters, are hotbeds for drug resistance.

Drug companies find it increasingly difficult to design new and improved drugs.

Cannon concludes that hope for improvement lies not with drug-makers, but with consumers changing their drug-abusing habits.

``It is a mistake to refuse an antibiotic cautiously prescribed by a trusted and knowledgeable physician for an identified bacterial infection.'' Cannon writes.

``But it is also a mistake to accept antibiotics casually prescribed as `protection' against the possibility of bacterial infection, or for an infection that is relatively trivial, and-or likely to clear up by itself, or one that can be treated by safer means.''