- WASHINGTON (Reuters) - New drug-resistant ``superbugs'', bacteria that defy
all known antibiotics, are virtually certain to pop up soon unless doctors
and hospitals crack down on procedures, health experts said Tuesday. Careless
use of antibiotics and slipshod hygiene were almost certainly responsible
for the rise of bacteria that resist the last-defense drugs -- methicillin
and vancomycin -- they told a news briefing sponsored by the National Foundation
for Infectious Diseases. ``We've seen dramatic increases...in the past
decade,'' Dr. William Jarvis, acting director of the hospital infections
program at the Centers for Disease Control and Prevention (CDC) in Atlanta,
told the briefing. ``Some infections are virtually untreatable.'' Bacteria
that resist penicillin are old hat, but when an infection does not respond
to something as strong as vancomycin, doctors get scared. Vancomycin-resistant
enterococci, which cause intestinal infections, are fairly common and three
cases of vancomycin-resistant staphylococcus have been reported.
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- This is unsettling as staphylococcus,
known generally as staph, is the number one cause of infection in the United
States. It can cause anything ranging from a pimple to deadly septic shock,
when the bloodstream becomes infected. ``I think vancomycin-resistant Staphylococcus
aureus (VRSA) is going to become more widespread,'' said Dr. Richard Duma,
director of infectious diseases at the Halifax Medical Center in Daytona
Beach, Florida. ``We were all shocked'' when the first case of VRSA in
people was reported in Japan in July of last year, Jarvis said. Two more
cases followed in the United States within weeks. Luckily, they all responded
to a cocktail of older drugs including ampicillin. ``We may not be so fortunate
in the future,'' Jarvis said.
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- ``Bacteria are very smart -- they learn
to develop resistance,'' he added. All of the patients had been very ill,
had developed methicillin-resistant staph infections, and been given vancomycin
over a period of weeks. Such misuse and overuse of antibiotics virtually
guaranteed the emergence of resistant bacteria, Jarvis said.
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- Vancomycin should be used only sparingly
he added. ``It's one of our precious miracles.'' The appearance of bacteria
resistant to first methicillin and then vancomycin scared the drug companies
into action after years of complacency in which no new antibiotics had
been developed. But it would be years before anything as strong and and
wide-acting as vancomycin was on the market, Jarvis said. Dr William Scheckler,
an epidemiologist at the University of Wisconsin and member of a national
panel on the spread of infections in hospitals, said hospitals did not
always do enough to prevent their spread.
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- Doctors, nurses and other healthcare
workers had to be urged to wash their hands before and after visiting each
patient -- a basic rule that many forget -- and all employees should be
vaccinated against flu and other diseases. Scheckler said each hospital
should have access to epidemiologists -- experts who monitor the spread
of disease across populations. This was becoming more important, as minor
diseases were being treated at home, with hospitals reserved for the sickest
people.
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- ``The patients in hospitals are older
and sicker and we are doing more things to them than we used to,'' Scheckler
said. Duma said drug-resistant superbugs were not the only frightening
thing waiting to surprise the American people. He predicted more exotic
diseases, such as the mysterious Ebola virus which has killed several hundred
people in Africa, would arrive in the United States via an infected airline
passenger. ``I think it's going to happen sooner or later and it's going
to scare the dickens out of everybody,'' he said.
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