Emerging Diseases: Article

Super Resistant Bacteria in U.S.

By The Associated Press

ATLANTA (AP) -- A staph germ that has resisted medicine's drug of last resort has shown up for the first time in the United States, the government said Thursday.

"The timer is going off," said Dr. William Jarvis, a medical epidemiologist with the Centers for Disease Control and Prevention. "We were concerned it would emerge here, it has emerged here and we are concerned we're going to see it popping up in more places."

A strain of staphylococcus aureus bacteria found in a Michigan man in July showed an intermediate level of resistance to vancomycin -- one step from immunity to the drug, the CDC said. The CDC and the Michigan department of health would not identify the man or say where he lives.

The patient, who suffered kidney failure, had been taking vancomycin for half a year for a recurring infection from an abdominal catheter used for kidney dialysis. He now is being treated with a combination of drugs, including vancomycin, Jarvis said.

The Michigan discovery came three months after a similar resistant strain was found in Japan.

In May, the CDC reported that a 4-month-old Japanese infant developed staph after heart surgery. That strain of staph also showed an intermediate resistance to vancomycin, and the baby was treated with other drugs.

Jarvis said the new strain is rare and should not deter people from seeking hospital care.

"The majority of people aren't going to be in danger of getting this," Jarvis said.

Nonetheless, U.S. hospitals were alerted to watch for the strain here.

"Now that you have two in such a short time, there will be heightened concern," said Richard Schwalbe, director of clinical microbiology at the University of Maryland.

Staph bacteria are the No. 1 cause of hospital infections. They are blamed for about 13 percent of the nation's 2 million hospital infections each year, according to the CDC. Overall, the 2 million infections kill 60,000 to 80,000 people.

The bacteria can collect on clothing, blankets, walls and medical equipment. Hospital workers can pass them on by hand, and they can cling to tubes inserted into the body.

To combat their spread, many hospitals across the country have restricted use of their most potent antibiotics and isolated their sickest patients.

Dr. Robert Haley, chief of epidemiology at the University of Texas Southwestern Medical Center in Dallas, said there's no reason hospitals can't eradicate resistant staph.

"These are unique, special strains that can be eradicated," said Haley, former chief of the CDC's hospital infections branch. "There needs to be aggressive surveillance in hospitals. Once you see it, don't let it stay and spread around the hospital until you can't get rid of it."

For patients, the rise of drug-resistant germs means that the medicine they get for their infection may not make them better, forcing doctors to switch to one or more of the 100 antibiotics now on the market.

However, many fear the time is growing near when there will be no alternative antibiotic to turn to.

Penicillin was a wonder drug that killed staph when it became available in 1947. Within a decade, some strains grew resistant, a development attributed to overuse of antibiotics and the failure of some patients to take their medicine properly.

Then came methicillin in the 1960s, then vancomycin, which was so potent it was regarded as the "silver bullet" against staph.

"There's going to be a lot of throwing up of arms with doctors saying now we have to live with this," Haley said. "That is not true. We must fight it vigorously. We are also going to have to be much more stingy with our use of vancomycin."

Pharmaceutical companies are working to develop new antibiotics.

An experimental new antibiotic called Synercid, made by Rhone-Poulenc, killed the strain found in the Japanese infant. In lab tests, it was effective on the strain of staph in the Michigan man, but tests showed his bacteria were not resistant to other antibiotics.

Synercid has not been approved yet for general use in the United States.

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