Emerging Diseases: Article

More Deadly Superbugs On The Way Disease Experts Say

By Maggie Fox
Health and Science Correspondent

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.

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.

"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.

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.

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.

"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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