Health News Digest

October 16, 2006

The Superbugs Are Here. Don’t Help Them AlongMethicillin-resistant Staphylococcus aureus

By  Michael D. Shaw

One of the greatest medical developments, the discovery and use of antibiotics, is now an example of science gone awry. The overuse of these drugs, combined with something less than what used to be called “clean living,” has helped to usher in highly resistant strains of pathogens. As a result, the medical community is now frantically searching for new modalities to treat patients with deadly symptoms.

More to the point, certain infections that we had presumably vanquished are back via a new breed of germs called “superbugs”—bacteria that are resistant to virtually all kinds of antibiotics. The best example of this danger is MRSA (Methicillin-resistant Staphylococcus aureus, a staph bacteria that triggers infections so sudden and virulent, that death can result within a few days. While common staph bacteria can cause skin infections, MRSA does that in a big way, but then works its way into far more dangerous respiratory infections, as well. Even more disturbing is the fact these superbugs can live for weeks on bed linens, computer keyboard covers, and under acrylic fingernails, according to leading authorities.

Bear in mind that viable MRSA can be detected on environmental surfaces days or even weeks after initial inoculation. This nasty bug can survive for eight weeks on acrylic fingernails, six weeks on computer keyboard covers, and five days on bed linens, researchers told a meeting of the American Society for Microbiology.

MRSA first became a health priority because of the serious pneumonias and bone and skin infections that left children dying because of a lack of an effective antibiotic. If you had brought your child to the doctor with any of those infections two years ago, an antibiotic that belonged to the penicillin group of antibiotics would be prescribed. According to Dr. Robert Daum, head of infectious diseases at the University of Chicago Children’s Hospital:  “We can’t do that anymore. We’ve abandoned that approach. All of these cillins, cephalosporin antibiotics—gone.”

Beyond in-hospital infections, MRSA is hitting people who are in other forms of close physical contact:  children in day care centers, prisoners in jails, and athletes on sports teams. Two of the NFL’s Miami Dolphins were hospitalized with MRSA last season. “A lot of athletes are playing with cuts in their skin. Or on AstroTurf, which is like a rug and can burn, abrade your skin,” says Daum. “Staph love it when we have a break in our skin. They just love it. They say, ‘This is just what I need to get inside.'”

And yet, even with estimates of more than 10,000 cases so far, doctors in many communities fail to properly recognize or treat MRSA. That means that doctors will have to stop writing, and patients will have to stop demanding, the 130 million prescriptions for antibiotics that are given out each year. Half of them are given to treat illnesses like the common cold, which are unaffected by these drugs. Some years ago, Tetracycline was given out like candy to every teenage kid with acne.

A few simple methods of preventing a staph or MRSA skin infection include washing hands thoroughly with soap and water or with an alcohol-based sanitizer, keeping cuts and scrapes clean and bandaged until healed, avoiding contact with other people’s wounds or bandages, and avoiding the sharing of items such as towels or razors. Check out the Centers For Disease Control’s webpage on MRSA.

Fortunately, the U.S. government started a public education campaign last fall, with a recommendation for pediatricians and parents:  No antibiotics for most childhood ear infections. Still, even though most of those infections go away on their own, parents may not stand for that, and will demand a “magic bullet.”

This dependency on antibiotics is neither necessary nor helpful. In reality, this medical savior is now a curse, a crutch for people who, while suffering from relatively minor (and short-lived) illnesses, abuse these drugs. The result is nothing short of catastrophic, particularly for children, the elderly, and anyone who is immunocompromised.

While the search is on for effective drugs to treat superbug infections, we must not let those very drugs become over-prescribed, causing another even more virulent strain to appear. We must never forget that common sense is a powerful and practical tool in public health.