Antibiotic-resistant staph increasing

[David Farber <dave () farber net>]

Begin forwarded message:

From: Randall <rvh40 () insightbb com>
Date: September 30, 2004 2:15:39 PM EDT
To: Dave Farber <dave () farber net>
Subject: Antibiotic-resistant staph increasing

-----Forwarded Message-----
From: Randall <rvh40 () insightbb com>
To: Cn <cuckoosnest () riddlemaster org>
Subject: [Cuckoosnest] Oh, joy ...
Date: Thu, 30 Sep 2004 14:10:06 -0400

http://messenger-inquirer.com/news/usworld/7646912.htm

By Linda A. Johnson
Associated Press

TRENTON, N.J. -- Flesh-eating bacteria cases, fatal pneumonia and
life-threatening heart infections suddenly are popping up around the
country, striking healthy people and stunning their doctors.

The cause? Staph, a bacteria better known for causing skin boils easily
treated with standard antibiotic pills.

No more, say infectious disease experts, who increasingly are seeing
these "super bugs" -- strains of Staphylococcus aureus unfazed by the
entire penicillin family and other first-line drugs.

Until a few years ago, these drug-resistant infections were unheard of
except in hospital patients, prison inmates and the chronically ill.
Now, resistant strains are infecting healthy children, athletes and
others with no connection to a hospital.

"This is a new bug," said Dr. John Bartlett, who chairs the committee on
antibiotic resistance at the Infectious Diseases Society of America.
"It's a different strain than in the hospital ... more dangerous than
other staph.

"Primary care physicians and ER doctors, they don't all know (about
this) and should," he said.

Bartlett, a professor at Johns Hopkins University School of Medicine,
treated three young Baltimore area women this year who got pneumonia
from this community-acquired resistant staph. All had to be put on
breathing machines, and one died, he said.

The infections will be a hot topic at the society's annual meeting this
week in Boston. The group has been warning that drug companies aren't
developing enough new antibiotics to avert a crisis.

Among the case reports to be discussed:

-- In Los Angeles, doctors at UCLA Medical Center treated 14 people with
necrotizing fasciitis, informally known as "flesh-eating bacteria," over
a 14-month stretch through April. Three needed reconstructive surgery,
and 10 spent time in intensive care.

"This is about as serious an infectious disease emergency as you can
get," said Dr. Loren G. Miller. "We don't know how these people got the
infection -- there doesn't seem to be a common thread."

-- In Corpus Christi, Texas, doctors at Driscoll Children's Hospital saw
fewer than 10 cases a year of community-acquired resistant staph
infections in the 1990s, then saw 459 in 2003, with 90 percent in
healthy children. Half were admitted to the hospital to get intravenous
antibiotics; a few developed life-threatening lung and heart infections
or toxic shock syndrome.

-- A Centers for Disease Control and Prevention study shows another new
twist: The resistant staph strain caused pneumonia in 17 people, killing
five, during last year's flu season. Only one had any risk factors for
the infection.

"Nobody dreamt when we were in medical school that this would ever enter
the community," said Dr. Rajendra Kapila of University of Medicine and
Dentistry of New Jersey in Newark.

He has treated several patients with the infections at University
Hospital there, including an itinerant golf caddie who kept getting
abscesses on his neck until he landed in the hospital two years ago.
Kapila linked the infections to abrasions from the man's golf bag strap.

In August, a man in his 40s with severe back pain turned out to have
such a severe staph infection in his spinal cord he was paralyzed
permanently, Kapila said.

Dr. John Segreti, an infectious disease specialist at Rush University
Medical Center in Chicago, estimates about 1 in 10 patients, some with
prior health problems, die from the infections.

Dr. Dan Jernigan, a CDC epidemiologist, said athletes, children and
military recruits are at higher risk. They are more likely to get cuts
and scrapes and share close quarters and items such as towels and soap.
Another factor is overuse of antibiotics, which tends to kill weak
bacteria and help hardier ones develop resistance.

"Clinicians will have to think differently about skin infections,"
Jernigan said. "We treat most skin infections without ever testing
them."

Testing will tell whether a strain is antibiotic-resistant, but the
tests are expensive.

There are no national statistics on these infections, but health
authorities are debating requiring doctors to report them.

The CDC has reported on numerous infection clusters, including Colorado
fencing club members, college football players in Pennsylvania and Los
Angeles, high school wrestlers in Indiana and dozens of Pacific
Islanders in Hawaii. Many patients were hospitalized, including most of
the athletes. At least two outbreaks have occurred among Native Alaskans
since 1996, with many cases linked to steam baths.

In New Jersey, infection clusters were reported in 2003 and earlier this
year involving two high schools and members of one family.

In Stafford, Texas, Janet Johnson's 13-year-old son Nicholas had such a
severe infection -- apparently after a minor football injury last
October -- that he was hospitalized for 5 1/2 weeks and nearly died. The
staph infected his lungs, blood and bones, destroying hearing in one ear
and making it difficult to walk.

"He was like a stroke victim," she said, but he's doing much better now
thanks to extensive physical therapy, repeated surgeries and continuing
use of antibiotics.




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