From savior to assassin - How killer germs have defeated our last antibiotic

Newark Star Ledger ^ | 12/7/03 | AMY ELLIS NUTT

[Incorrigible]

The only thing Robert Thompson knows for certain is that his patient died. Almost everything else about Ryan Donahoe's illness remains a mystery -- and a warning. Now, five months later, the Seattle physician still asks the same question.

How could a strong, athletic 19-year-old walk into a hospital emergency room complaining only of fever and lower back pain and seven days later end up dead?

[Incorrigible]

Uh oh!

[A CA Guy]

What did Reagan, Bush I and Bush II know and when did they know it?

Look for this to be the new cry in the media!

[gunnedah]

America has turned her back on the things that made her great and pay day is just around the corner.

[b4its2late]

Damn germs.

[IronJack]

While this is certainly a cause for concern, this article strikes me as unduly alarmist, almost sensationalist. The medical community has been predicting this biological disaster for a decade now, and it is not coming to pass any more than the AIDS pandemic.

I'm always a little skeptical when I hear these apocalyptic predictions. Fear is never a safe motivator for radical social change.

[King Prout]

It has been a long time in coming, but it looks like its toe is now in the door.

[A CA Guy]

I almost never used antibiotics, yet America and the whole world will be involved in a little population control because they have been overused and these viruses are mutating.

It's not a big deal, let's say half the world's population dies...so what?

First, we are all going to die.
Secondly, it makes more room for new people.

There have been things that have taken out large portions of populations historically, this is just another one.

The world (Minus some people) will go on.


But the real question is:
WHAT DID CLINTON/GORE KNOW AND WHEN DID THEY KNOW IT?

[Travis McGee]

Very Scary Stuff!

[null and void]

AIIIIEEEE! We're all gonna DIE!!!!

[bert]

.....have caused mutant bacteria to flourish.....

More correctly "have allowed mutant bacteria to flourish".

A mutating bacteria is provided an enviroment to thrive with no existing antibiotic to kill it.

[gunnedah]

Yeh,but I dont want to take a chance on being one of the minuses,like I want to go to heaven but I dont want to die.
Maybe I should become a politician with all these selfish desires!

[absinthe]

While this is certainly a cause for concern, this article strikes me as unduly alarmist, almost sensationalist. The medical community has been predicting this biological disaster for a decade now, and it is not coming to pass any more than the AIDS pandemic.

I'm always a little skeptical when I hear these apocalyptic predictions. Fear is never a safe motivator for radical social change.

I agree. The author talks about the millions killed by the bubonic plague (although it's never been definitively proven what organism caused the plague) and the hundreds of thousands of Civil War soldiers killed by wound infections.

She then describes a handful of case reports of modern MRSA infections. But where's the hundreds of thousands or millions dying? Why does she have to list individual cases if the situation is so bad?

She also needs to better research her pharmacology. Vancomycin is not the last resort. Many strains of MRSA are susceptible to minocycline (Vibramycin), or even trimethoprim/sulfamethoxazole (Bactrim or Septra). Linezolid (Zyvox) is a relatively new drug active against MRSA. Mupirocin (Bactroban) is a topical drug active against MRSA; it can be applied directly to an infected skin lesion.

I work in an ER, and see very few serious resistant infections in young, healthy people. Most MRSA infections are, as she correctly notes, complications in older, sicker patients.

On the other hand, I am alarmed about the reports of MRSA infections showing up in swimmers at Daytona Beach (my home town!) or gay men without immune problems. They're still anecdotal cases, but my eyebrow is raised.

[steve86]

this article strikes me as unduly alarmist, almost sensationalist.

Only alarmist if you interpret it as a threat to any one specific individual - the danger to you or me personally is probably slight at this time. But to the population and the medical system it is real and tangible. Think of the hospital in the article closing a surgical ward due to just one case. What if every hospital had 3 or 4? This outcome is not hypothetical, it is inevitable, unless an effective antibiotic or some other treatment is developed. And I can reasonably avoid most AIDS exposure but not this.

[tarheal]

IronJack is right.
The article is factually correct on many points; overuse of antibiotics has resulted in development of resistant bacteria more rapidly than would have occurred otherwise. It is my opinion that that is all that has happened, and we are a few decades ahead of where we would be if I and all of my colleagues had used antibiotics "by the book." Eventually though, we would be where we are, because the bugs will always survive.

BUT it is alarmist and irresponsible to start talking about "doomsday bugs." 99+% of all bacteria are still sensitive to readily available antibiotics. The few people who die due to overwhelming infection are typically old, debilitated, diabetic, or immunosuppressed patients who 50 years ago would not have survived their primary illness long enough to get an infection. Consider that even a century ago, when there were no antibiotics at all, most people did not die right away when they caught an infectious disease. Granted a lot did, but it was improvements in hygiene and sanitation that was responsible for the bulk of the lengthened lifespan. Also keep in mind that some of the greatest killers in history were not bacteria, but viruses (samllpox, flu, polio), and we are now just beginning to develop antiviral medications. So yes, if you are chronically weakened by diabetes, heart failure, AIDS, or advanced age, these bugs are something to worry about, and do your best to keep healthy and out of hospitals (don't even visit sick friends). If you are otherwise healthy, your chances of succumming to an infectious disease are much less than they were 100 or even 50 years ago.

What to do? On a micro scale, don't demand an antibiotic prescription from your doctor if what ails you appears to be viral. If you are serving as a juror in a medical malpractice trial, have a little sympathy for the defendent doctor whois being attacked by a hired gun plaintiff's expert who claims that the plaintiff would have done so much better if only the right antibiotic had been prescribed a day earlier. Most important, keep the government out of the pharmaceutical business. Nothing kills innovation like government intervention, threats of price controls, or higher taxes on the people who risk their time and careers looking for the next effective drug.

[steve86]

Mupirocin (Bactroban) is a topical drug active against MRSA; it can be applied directly to an infected skin lesion.

The problem with these topical drugs, even if specific for the pathogen, is that the infection is not recognized as resistant early enough - the necrotizing bacteria may spread to internal organs within just hours. I spoke to a dermatologist who said he could actually watch the progression of the dead tissue move up the leg of an infected patient. No medical facility is going to bring out the heavy hitter antibiotics just because a patient shows up with a boil. And if they did a whole new legion of resistant bacteria would be launched.

[handk]

Ozone kills all bacteria, viruses, pathogens and fungi upon contact.

Zero side effects.

Used routinely in Europe for over 50 years.

Illegal in America.

It's a "profit" thing.

[RLK]

In short, our saviors have become our assassins.

-----------------------

No, they haven't. I, for one, would have died long ago without them.

[RLK]

In short, our saviors have become our assassins.

-----------------------

No, they haven't. I, for one, would have died long ago without them. The people who are dying of resistance strains would be dying anyway. Don't blame it on the medications.

[xrp]

In July 1997, a 7-year-old African-American girl was admitted to a hospital in the Minneapolis area with a fever of 103 degrees and a staph infection in her right hip. She died after five weeks.

In January 1998, a 16-month-old Native American girl from North Dakota was taken to a local hospital with a fever of 105.2 degrees. She suffered toxic shock and died within two hours.

In January 1999, a 13-year-old girl in rural Minnesota was brought to the hospital with a small boil on her lower lip, fever and respiratory distress. She died a week later.

In February 1999, a 1-year-old North Dakota boy was admitted to a hospital with a lung infection, vomiting and dehydration. He died the next day.

Last spring, exactly four years after the 1-year-old North Dakota boy died, two Newark children were admitted to the University of Medicine and Dentistry of New Jersey, three weeks apart, with staph infections identical to the strain that killed all four Midwesterners.

What was the ??????-American label for the other children???

[mel]

I am far more concerned about VRE and the limited number of antibiotics to combat this disease. In the realm of things, the misuse of antibiotics is far more of a concern to me than if some talk show host got hooked on drugs after developing chronic back pain.