Superbugs Increasing
Rapidly - Cost US
$5 Billion A Year
By Maggie Fox
Health and Science Correspondent
WASHINGTON (Reuters) - Virtually all strains of the common staph bacterium are now resistant to penicillin, other bugs are rapidly developing drug-resistant forms, and the costs are rocketing, yet no one is tracking these ``superbugs'' in an organized way, disease experts said Thursday.
They said governments, doctors, drug companies and academic researchers must join forces to find out where and why drug-resistant microbes are emerging.
``This is a global public health problem,'' Dr. James Hughes, assistant surgeon general and director of the National Center for Infectious Diseases at the Centers for Disease Control and Prevention (CDC), told a seminar.
Despite repeated warnings that soon some infections would emerge that no drugs could treat, no one has taken concerted action, he said, and the U.S. government is not helping. Hughes said the CDC drew up a plan in 1994 for tracking emerging infectious diseases.
``We estimated in 1994 that the cost for full, annual implementation of the plan would be $125 million,'' he said. So far Congress has allotted $59 million, he said. President Clinton has asked for $20 million for 1999, which would still bring the funding to just $79 million.
``We've got a long way to go,'' he said. The Institute of Medicine seminar was part of a series of forums on infectious diseases. Experts discussed a report that found, for example, that 90 percent of all strains of Staphylococcus aureus, the most common cause of infections, some of them deadly, now resisted penicillin. Yet no one is keeping a careful eye on how this is happening.
``No country, including the United States, has a reliable, longitudinal, full-service antimicrobial resistance surveillance program with comprehensive focus, nor is there a comprehensive database for monitoring trends in antimicrobial usage,'' they wrote.
``Antibiotic-resistant bacteria generate a minimum of $4 billion to $5 billion in costs to U.S. society and individuals yearly, and in 1992 the 19,000 deaths directly caused by hospital-acquired infections made them the 11th leading cause of death in the U.S. population,'' they wrote.
One reason for their spread is the widespread use of antibiotics. The more bacteria are exposed to the drugs, the easier it is for them to evolve into resistant forms. Doctors are overusing antibiotics, they said, in part because more children than ever are showing up with infections, and their parents press hard for them to be given drugs. No quick and easy test exists that will tell if an infection is caused by a bacterium or a virus -- or, if it is bacterial, whether it is caused by a drug-resistant strain. ``We need more information on factors that influence physician prescription practices and patient demand,'' Hughes said.
People fail to take simple precautions like washing their hands, even in hospitals, or taking a full course of antibiotics so no bacteria survive to become resistant. ``Every one of us are to blame,'' said Dr. Gail Cassell, vice president for infectious disease research at Eli Lilly & Co. Doctors and dentists are not trained in how microbes grow to resist drugs, she added. ``There's a great need for public education at large,'' she said.
The need is urgent, Hughes said. ``We are overdue for the next influenza epidemic,'' he told the seminar. Flu is a virus and thus antibiotics are useless against it. But the bacterial infections that often develop in people who have flu were once easily treated. With the rise of drug-resistant forms, the next epidemic of flu could see serious complications, Hughes said.

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