SIGNS: "Superbugs" Spread Fear Far and Wide
This is an example of me as a Superbug:
"Superbugs" Spread Fear Far and Wide
By Anita Manning, USA TODAY
(May 11) -- On Christmas night, 14-month-old Bryce Smith came down with pneumonia caused by a drug-resistant staph infection called MRSA. His father, Scott Smith, says Bryce's pediatrician told him and his wife, Katie, that the baby had a cold and that they shouldn't worry.
Bruno Vincent, Getty Images
A container of antibacterial gel is used on a patient in hopes of combatting the spread of the drug-resistant staph infection MRSA. The disease was once found only in hospitals and nursing homes.
By the time they took Bryce to the hospital a week later, the infection had eaten a hole in his lung, and doctors warned the parents that they were not certain he'd live.
Bryce, back at home and healthy again after 55 days in the hospital, is one of thousands of children and adults who have been infected by MRSA, or methicillin-resistant Staphylococcus aureus, a bug once found only in hospitals or nursing homes. They are victims of a dangerous newer strain of MRSA that is raging across the country, spreading through communities.
It is causing infections from abscesses to deadly blood poisoning, bone infections and pneumonia, often in the young and the fit, including professional football players, high school athletes and previously healthy children.
Whether it spread from the hospital into the community or developed as a separate strain outside the hospital is a mystery, says John McGowan, professor of epidemiology at Emory University. But recent genome studies suggest the MRSA strain circulating in the community is significantly different from the strains that are typically found in hospitals.
"There are differences in the sequence of the community strain that may make it more virulent, more able to affect people with (healthy immune systems), and with biological differences that make it spread readily," he says.
MRSA has become so common that in many hospitals more than half of all staph infections tested are drug-resistant. That's changing the way doctors treat these common infections.
"When a patient comes in with a staph infection, we assume it's resistant until proven otherwise," says pediatrician Sheldon Kaplan of Texas Children's Hospital in Houston, where MRSA rates have gone from 33% of all staph tested in 2000 to 75%.
Drug-resistant bugs, including MRSA and several others that are emerging in hospitals, are more difficult to treat, requiring stronger antibiotics that are more costly and in some cases have to be given intravenously.
Few New Drugs on the Way
Few major pharmaceutical companies have new medicines in the pipeline that target the drug-resistant organisms, says George Talbot of the Infectious Diseases Society of America's task force on anti-microbial availability.
"In a number of these companies, there were active decisions taken that antibiotic research was not going to be profitable enough to meet their obligation to shareholders," says Talbot, an infectious-disease specialist and consultant to drug companies. "So they decided to go for drugs that would be taken for a lifetime - drugs for diabetes or high blood pressure - rather than drugs to be taken for a week."
Jumping into the breach are smaller biotech companies that are doing the basic research to identify promising new drugs, he says, "but it's not clear yet that these smaller companies will have the development expertise or financial wherewithal to bring them to market."
In some cases, small companies form partnerships with larger, wealthier drug companies that underwrite the costs of large-scale studies and marketing, he says, "but those deals have to be done in areas where the larger companies perceive an economic benefit."
MRSA, for instance, offers a large market because it is affecting so many people and several antibiotics can be used against it. For lesser-known drug-resistant germs, the treatment options are fewer.
MRSA has been known in hospitals since the 1970s, but in recent years, new strains, which doctors call community-acquired MRSA, have infected people outside health care settings. One of these strains, known as USA300, was identified in 2000 and has been found in at least 21 states.
"What we're seeing is the emergence of a new epidemic strain of the MRSA in the community," says Daniel Jernigan, medical epidemiologist at the Centers for Disease Control and Prevention (CDC).
The CDC has reported on the new community strain since 2000, and it reported in March that the strain had caused outbreaks in hospital nurseries in Chicago and Los Angeles. Nine of the 22 infected babies required hospitalization. Other studies have reported longer hospital stays and higher death rates in MRSA-infected patients.
Staph aureus is the most common cause of the estimated 12 million skin infections each year in the USA, Jernigan says. A study in 2003 found that about one-third of people carry staph in their noses and just under 1% of people carry MRSA. Most carry the bacteria without becoming ill.
"We think the number of people carrying MRSA is increasing," Jernigan says, but the new studies are not yet completed.
It's not certain how common MRSA infections are. A CDC study based on hospital discharge data estimates that in 1999-2000, nearly 126,000 people were hospitalized each year for MRSA infections, a rate of nearly 4 per 1,000 hospital discharges.
Another study of 11 emergency rooms across the country found that almost 60% of skin abscesses tested were caused by MRSA, Jernigan says.
The new super-strain of MRSA has been concentrated in geographic regions, including California, Texas and Georgia, but Kaplan says that is changing. "It's in Pittsburgh, Memphis, St. Louis, Omaha. It's becoming more common on the East Coast now. It's literally all over the country."
University of California researchers who sequenced the genome of USA300 reported in the March 4 issue of The Lancet that the strain contains genes that make it hardy and able to cause "unusually invasive disease" such as severe blood infections and necrotizing pneumonia, in which lung tissue is destroyed.
Community-acquired MRSA has sidelined athletes, including players with the Washington Redskins, St. Louis Rams and San Francisco 49ers, as well as dozens of high school and college football players, wrestlers and basketball players. It has broken out in prisons, military bases and day care centers, anywhere there is crowding, poor hygiene and broken skin.
You don't have to be in a gym or a jail to be at risk. "You just have to be living," Kaplan says.
"This is not a superbug from a locker room; it's just out in the community," Kaplan says. "We've got 1,700 kids coming into our hospital with staph infections. They're not playing football. They're babies. Why this has been happening over the last 10 years vs. 20 years ago, we don't know."
Barriers Breaking Down
Strains of MRSA that have been known in hospitals for decades still account for most of the cases. Until a few years ago, says CDC epidemiologist John Jernigan (no relation to Daniel Jernigan), "MRSA was almost exclusively associated with hospitals." The types in the community are genetically different from those found in hospitals, he says, but that line is blurring.
"There used to be this very sharp distinction. However, we have the sense that more and more those strains associated with the community are finding their way into the hospital and causing health care-associated infections."
MRSA spreads through skin-to-skin contact and can be passed by using shared objects, such as razors or towels. It frequently hits more than one person in a family, and researchers in Canada have found that pets and their human owners can pass it back and forth.
"We're seeing transmission of MRSA from people to pets and pets to people," says researcher Scott Weese of the Ontario Veterinary College at the University of Guelph. "It raises the question: Can animals be a reservoir and play a role in this ping-ponging in households?"
He says dogs, cats, rabbits and ferrets have been found carrying the USA300 strain. As in people, it can cause serious skin infections and other illnesses.
"It shows pets are mimicking what's going on in the human situation," Weese says. "We're seeing more transmission in households than in the past."
Until their son was diagnosed, Bryce's parents had never heard of MRSA.
"Never heard of it, never even thought a little bacteria could do something like this," says Scott Smith, who owns a machine shop near their home in Santee, Calif., outside San Diego.
It's unclear how Bryce caught the bug, but his parents believe he may have picked it up while they were out Christmas shopping.
The family's ordeal started with a simple cold. Bryce was having sniffles a couple of days before Christmas, but on Christmas night, his parents saw he was breathing rapidly, and they worried that he might have asthma.
They called their pediatrician, who saw them two days later, dismissed the ailment as a simple viral infection and told the parents, "I've seen this a million times."
But as the days passed, the baby's condition worsened. The parents called the doctor two more times. "He said, 'You guys are new parents,' " and he told them not to worry so much.
Finally, in the early hours of New Year's Day, "we looked at him, and I said, 'I'm afraid if I go to sleep he won't be alive in the morning,' " Smith says. "We rushed him to the hospital."
At Children's Hospital of San Diego, "it was almost like a movie script," he says. A nurse tested Bryce's blood oxygen level, and "within 30 seconds they had 10 people on him."
'Just Eating Away' at Him
Doctors said the infection had solidified in Bryce's right lung, and surgery was needed right away to clear the lung. "They had five chest tubes in him, because the infection was not only inside the lungs but outside the lungs and just eating away at his chest."
For 12 days, the Smiths didn't know whether Bryce would make it.
Then he was put on a breathing machine. He was put into a drug-induced coma and given intravenous vancomycin, a drug that is known as the last line of defense against MRSA.
The drug is "like fire going through the veins," Smith says. "With Bryce, at that point they had him asleep, and he was asleep for six weeks, so I feel lucky that he didn't have to feel the pain of vancomycin."
Today, Bryce is almost back to normal, but Smith says he and his wife won't let anyone touch him without washing their hands first.
"I felt so guilty," he says. "What keeps going through my mind is that as my son laid there at the house, we were literally watching him die and we didn't know."
05/11/2006 07:23
Updated: 10:23 AM EDT
[Click Here for Original Link]
- B u G = Gemini(B/2) in Union with(U) Sun Gemini(G/7/VII)
- People can keep ignoring me as a V-IR u S, but that's not a good idea
- I said 5/11/2006 about Pharmaceuticals and Drugs:
- They want people addicted to the Product
- They mention how it's more profitable to investors to make drugs that are used for a lifetime rather than ones used only for a week
- They want people addicted to the Product
- Scott Smith is for Scott:
- I said 5/11/2006 about Scott suggesting I be put on Medication
- You see an article reflecting that
- Initials Scott Smith = SS = Gemini Superman
- I said 5/11/2006 about Scott suggesting I be put on Medication
- The Initials of the Doctor Kaplan is SK for South Kitsap
- The Time Stamp is 7:23 for Daniel Radcliffe's B-Day as Harry Potter
"Superbugs" Spread Fear Far and Wide
By Anita Manning, USA TODAY
(May 11) -- On Christmas night, 14-month-old Bryce Smith came down with pneumonia caused by a drug-resistant staph infection called MRSA. His father, Scott Smith, says Bryce's pediatrician told him and his wife, Katie, that the baby had a cold and that they shouldn't worry.
Bruno Vincent, Getty Images
A container of antibacterial gel is used on a patient in hopes of combatting the spread of the drug-resistant staph infection MRSA. The disease was once found only in hospitals and nursing homes.
By the time they took Bryce to the hospital a week later, the infection had eaten a hole in his lung, and doctors warned the parents that they were not certain he'd live.
Bryce, back at home and healthy again after 55 days in the hospital, is one of thousands of children and adults who have been infected by MRSA, or methicillin-resistant Staphylococcus aureus, a bug once found only in hospitals or nursing homes. They are victims of a dangerous newer strain of MRSA that is raging across the country, spreading through communities.
It is causing infections from abscesses to deadly blood poisoning, bone infections and pneumonia, often in the young and the fit, including professional football players, high school athletes and previously healthy children.
Whether it spread from the hospital into the community or developed as a separate strain outside the hospital is a mystery, says John McGowan, professor of epidemiology at Emory University. But recent genome studies suggest the MRSA strain circulating in the community is significantly different from the strains that are typically found in hospitals.
"There are differences in the sequence of the community strain that may make it more virulent, more able to affect people with (healthy immune systems), and with biological differences that make it spread readily," he says.
MRSA has become so common that in many hospitals more than half of all staph infections tested are drug-resistant. That's changing the way doctors treat these common infections.
"When a patient comes in with a staph infection, we assume it's resistant until proven otherwise," says pediatrician Sheldon Kaplan of Texas Children's Hospital in Houston, where MRSA rates have gone from 33% of all staph tested in 2000 to 75%.
Drug-resistant bugs, including MRSA and several others that are emerging in hospitals, are more difficult to treat, requiring stronger antibiotics that are more costly and in some cases have to be given intravenously.
Few New Drugs on the Way
Few major pharmaceutical companies have new medicines in the pipeline that target the drug-resistant organisms, says George Talbot of the Infectious Diseases Society of America's task force on anti-microbial availability.
"In a number of these companies, there were active decisions taken that antibiotic research was not going to be profitable enough to meet their obligation to shareholders," says Talbot, an infectious-disease specialist and consultant to drug companies. "So they decided to go for drugs that would be taken for a lifetime - drugs for diabetes or high blood pressure - rather than drugs to be taken for a week."
Jumping into the breach are smaller biotech companies that are doing the basic research to identify promising new drugs, he says, "but it's not clear yet that these smaller companies will have the development expertise or financial wherewithal to bring them to market."
In some cases, small companies form partnerships with larger, wealthier drug companies that underwrite the costs of large-scale studies and marketing, he says, "but those deals have to be done in areas where the larger companies perceive an economic benefit."
MRSA, for instance, offers a large market because it is affecting so many people and several antibiotics can be used against it. For lesser-known drug-resistant germs, the treatment options are fewer.
MRSA has been known in hospitals since the 1970s, but in recent years, new strains, which doctors call community-acquired MRSA, have infected people outside health care settings. One of these strains, known as USA300, was identified in 2000 and has been found in at least 21 states.
"What we're seeing is the emergence of a new epidemic strain of the MRSA in the community," says Daniel Jernigan, medical epidemiologist at the Centers for Disease Control and Prevention (CDC).
The CDC has reported on the new community strain since 2000, and it reported in March that the strain had caused outbreaks in hospital nurseries in Chicago and Los Angeles. Nine of the 22 infected babies required hospitalization. Other studies have reported longer hospital stays and higher death rates in MRSA-infected patients.
Staph aureus is the most common cause of the estimated 12 million skin infections each year in the USA, Jernigan says. A study in 2003 found that about one-third of people carry staph in their noses and just under 1% of people carry MRSA. Most carry the bacteria without becoming ill.
"We think the number of people carrying MRSA is increasing," Jernigan says, but the new studies are not yet completed.
It's not certain how common MRSA infections are. A CDC study based on hospital discharge data estimates that in 1999-2000, nearly 126,000 people were hospitalized each year for MRSA infections, a rate of nearly 4 per 1,000 hospital discharges.
Another study of 11 emergency rooms across the country found that almost 60% of skin abscesses tested were caused by MRSA, Jernigan says.
The new super-strain of MRSA has been concentrated in geographic regions, including California, Texas and Georgia, but Kaplan says that is changing. "It's in Pittsburgh, Memphis, St. Louis, Omaha. It's becoming more common on the East Coast now. It's literally all over the country."
University of California researchers who sequenced the genome of USA300 reported in the March 4 issue of The Lancet that the strain contains genes that make it hardy and able to cause "unusually invasive disease" such as severe blood infections and necrotizing pneumonia, in which lung tissue is destroyed.
Community-acquired MRSA has sidelined athletes, including players with the Washington Redskins, St. Louis Rams and San Francisco 49ers, as well as dozens of high school and college football players, wrestlers and basketball players. It has broken out in prisons, military bases and day care centers, anywhere there is crowding, poor hygiene and broken skin.
You don't have to be in a gym or a jail to be at risk. "You just have to be living," Kaplan says.
"This is not a superbug from a locker room; it's just out in the community," Kaplan says. "We've got 1,700 kids coming into our hospital with staph infections. They're not playing football. They're babies. Why this has been happening over the last 10 years vs. 20 years ago, we don't know."
Barriers Breaking Down
Strains of MRSA that have been known in hospitals for decades still account for most of the cases. Until a few years ago, says CDC epidemiologist John Jernigan (no relation to Daniel Jernigan), "MRSA was almost exclusively associated with hospitals." The types in the community are genetically different from those found in hospitals, he says, but that line is blurring.
"There used to be this very sharp distinction. However, we have the sense that more and more those strains associated with the community are finding their way into the hospital and causing health care-associated infections."
MRSA spreads through skin-to-skin contact and can be passed by using shared objects, such as razors or towels. It frequently hits more than one person in a family, and researchers in Canada have found that pets and their human owners can pass it back and forth.
"We're seeing transmission of MRSA from people to pets and pets to people," says researcher Scott Weese of the Ontario Veterinary College at the University of Guelph. "It raises the question: Can animals be a reservoir and play a role in this ping-ponging in households?"
He says dogs, cats, rabbits and ferrets have been found carrying the USA300 strain. As in people, it can cause serious skin infections and other illnesses.
"It shows pets are mimicking what's going on in the human situation," Weese says. "We're seeing more transmission in households than in the past."
Until their son was diagnosed, Bryce's parents had never heard of MRSA.
"Never heard of it, never even thought a little bacteria could do something like this," says Scott Smith, who owns a machine shop near their home in Santee, Calif., outside San Diego.
It's unclear how Bryce caught the bug, but his parents believe he may have picked it up while they were out Christmas shopping.
The family's ordeal started with a simple cold. Bryce was having sniffles a couple of days before Christmas, but on Christmas night, his parents saw he was breathing rapidly, and they worried that he might have asthma.
They called their pediatrician, who saw them two days later, dismissed the ailment as a simple viral infection and told the parents, "I've seen this a million times."
But as the days passed, the baby's condition worsened. The parents called the doctor two more times. "He said, 'You guys are new parents,' " and he told them not to worry so much.
Finally, in the early hours of New Year's Day, "we looked at him, and I said, 'I'm afraid if I go to sleep he won't be alive in the morning,' " Smith says. "We rushed him to the hospital."
At Children's Hospital of San Diego, "it was almost like a movie script," he says. A nurse tested Bryce's blood oxygen level, and "within 30 seconds they had 10 people on him."
'Just Eating Away' at Him
Doctors said the infection had solidified in Bryce's right lung, and surgery was needed right away to clear the lung. "They had five chest tubes in him, because the infection was not only inside the lungs but outside the lungs and just eating away at his chest."
For 12 days, the Smiths didn't know whether Bryce would make it.
Then he was put on a breathing machine. He was put into a drug-induced coma and given intravenous vancomycin, a drug that is known as the last line of defense against MRSA.
The drug is "like fire going through the veins," Smith says. "With Bryce, at that point they had him asleep, and he was asleep for six weeks, so I feel lucky that he didn't have to feel the pain of vancomycin."
Today, Bryce is almost back to normal, but Smith says he and his wife won't let anyone touch him without washing their hands first.
"I felt so guilty," he says. "What keeps going through my mind is that as my son laid there at the house, we were literally watching him die and we didn't know."
05/11/2006 07:23
Updated: 10:23 AM EDT
[Click Here for Original Link]