“SUPER BUGS”: DANGEROUS BACTERIAL INFECTIONS

This month I would like to address the issue of “Super Bugs”. These are bacteria that are resistant to all or most of our present stock of antibiotics. Some are becoming more pervasive and attacking seemingly healthy people.

Last year the man who owns the apiary where I get my raw honey related his “Super Bug” story. He had tripped on his non-paved driveway and scraped his hands. A few days later he couldn’t get out of bed, had a fever, and had pain in his back and his legs. He spent 3 weeks in the hospital, unconscious part of the time. He had an infection which ran unchecked throughout his body and didn’t respond to the first wave of antibiotics.

Fortunately, his story had a happy ending. Many are not so lucky. Hospitals are not a good place to be sick. In the U.S., almost 2 million patients pick up an infection while hospitalized. This is out of 35 million admissions. I do not find this a comforting statistic! Out of these 2 million, two thirds are infected with an organism resistant to at least one antibiotic. It is estimated that 100,000 patients die of hospital-acquired infections each year.

The cost of treating these hospital infections is approximately $30 billion dollars!

One of the most feared hospital infections is MRSA (methicillin resistant staphylococcus aureus). Most of us have heard about “staph” infections. “Staph” is short for Staphylococcus aureus. Staph is the common cause of skin infections like impetigo, boils and abscesses. Some staph can cause more serious diseases like pneumonia or blood infections. It is estimated that 25-30% of the population normally have staph on their skin or in their nose.

Most staph infections respond to typical antibiotics. However, a resistant staph strain is called MRSA. These staph bacteria are resistant to the antibiotic methicillin and the other penicillin related types. Now there is also VRSA which are staph bacteria that are resistant to vancomycin, the drug that could always be counted on as a last resort.

Up until recently, these “Super Bugs” were confined almost exclusively to the hospital. Now, as with my apiary friend, more cases are being contracted outside the hospital.

How did we come to this state of seemingly incurable infections? Modern day drug therapy is supposed to save us from this. In the past it certainly seemed like it would.

According to the Center for Disease Control (CDC), in 1974 two percent of hospital staph infections did not respond to the standard antibiotics of the day and alternatives had to be used. Today that figure is 60%! The bacteria evolved and become more and more resistant to antibiotics, and this is not confined to just the staphococcus varieties.

For instance, an intestinal bug called Clostridium difficile (CD) has mutated into a more toxic strain and is showing up in the hospitals. CD typically causes diarrhea. However, the new strain produces about 20 times the amount of toxin as the “normal” strain, and can destroy a colon in less than a week.

According to many authorities, the overuse of antibiotics is the biggest cause of these “Super Bugs”.

With the introduction of penicillin in the early 1940’s, the hope of vanquishing bacterial infections seemed at hand. However, by the mid 1940’s bacteria resistant to penicillin were already emerging. No problem. Many more antibiotics were being introduced to the market. Also, in the 1950’s these antibiotics started being used in animal feed.

The use of antibiotics became ubiquitous. Patients expected a prescription for an antibiotic for even the most trivial malady including the common cold, which is caused by a virus, not a bacteria. Doctors obliged, and antibiotics were handed out like “chicklets”. Today it is estimated there are 130 million prescriptions per year for antibiotics. In 1997, a study showed that half of patients with a common cold were given antibiotics by their doctors.

Over time more and more antibiotic-resistant strains of bacteria have developed.Vancomycin had been the antibiotic of last resort to handle difficult infections. As its use has increased more and more vancomycin-resistant bacteria are emerging.

As all this has been occurring, the drug companies have been cutting back on their antibiotic research.

It costs about a billion dollars to bring a new drug to the market over 10-15 years. An antibiotic is administered to a patient for about two weeks. A statin drug to lower cholesterol is given daily. Given the potential return on investment, where would you put your money? Also, as the antibiotics get more powerful, the risk of serious side effects increases. For example, the antibiotic Trovan was linked to cases of liver failure and therefore must be used very judiciously. In our litigious society, adverse reactions to drugs often lead to costly lawsuits.

There are fewer antibiotics in development as compared with past years, and, even when a new drug is developed bacteria become resistant to it in a short period of time. What do we do? Next month I will explore alternatives to antibiotics.

© 2006, Mark A. Breiner, DDS

The information presented is for educational purposes only. You should consult a qualified dentist or health practitioner for diagnosis and treatment.