One of the most important health issues faced by humans in the 21st Century is the rise of alleged super bugs. This programme tells the viewer what most people already know.
As science gets wiser, so do the bugs. Rates of drug-resistant bacteria infecting patients in the community and in hospital has increased steadily in recent years, according to new studies found in the June 15 issue of Clinical Infectious Diseases, available online.
Drug resistance in micro-organisms has become a problem due in part to inappropriate prescribing and overuse of antibiotics. These drug-resistant super bugs could infect humans and cause health problems that are difficult to address with standard antibiotic regimens. One defendant is methicillin-resistant Staphylococcus Aureus, or MRSA, an organism that was associated mainly with hospital-acquired infections, but is becoming increasingly common in the general community, as has been reported recently in the medical literature. This can cause problems ranging from skin infections to severe infections, bloodstream and even death.
Researchers at Baylor College of Medicine and Texas Children’s Hospital conducted a three-year study of S. Aureus infections in children. They found that between the community-acquired S. Aureus isolates, the proportion of isolated MRSA has reached 76 percent in 2003. Over the passed three years, the number of community-acquired MRSA infections were more than twice. MRSA isolates caused skin and soft tissue infections, usually, and more than 60 percent of these children were admitted to hospital.
The rapid rise in pediatric community-acquired MRSA infections in Texas, should grow red flags for health care workers everywhere. There have been deaths related to this organism,although the vast numbers are skin and soft tissue infections, said Sheldon Kaplan, MD, lead author of the study Texas. He added that because this very dramatic increase in MRSA infections, doctors must learn what percentage of staphylococcal isolates are resistant drug in their own communities so they can grow and monitor to adjust your treatment accordingly.
Prevention of MRSA infections mainly involves common sense. If you get a cut or abrasion, try to keep the towels clean and dry, said Dr. Kaplan. Most importantly, he added, wash hands, wash hands hands.
And if regular drug-resistant bacteria were not bad enough, some bacteria have become multi drug resistant (MDR). Researchers at Beth Israel Deaconess Medical Center and Harvard Medical School studied the prevalence of bacteria resistant to three or more drugs over a period of six years. From 1998 – 2003 there was a significant increase in the incidence of patients carrying MDR bacteria when they were admitted to hospital. Of the four species of MDR bacteria that the researchers examined, three of them – including Escherichia coli, a familiar bug that can cause urinary tract infections.
Spread of multi drug resistance in bacteria appears to have two main causes, according to Aurora Pop-Vicas, MD, lead author of the study Massachusetts. The first is the intrinsic ability of bacteria to mutate and acquire resistance to antibiotics under pressure. The second is the spread of MDR bacteria from patient to patient, often in hospitals or long-term care facilities such as nursing homes. In the study, living in a long term care facility, being 65 years or older or antibiotics for two or more weeks were all factors that increased the likelihood of people carrying MDR bacteria admission to hospital.
Physicians should be aware of risk factors for MDR bacterial infections, Dr. Pop-Vicas said, and should be judicious in prescribing antibiotics. Treating infections caused by MDR bacteria is a therapeutic challenge, Dr. Pop-Vicas said, because for severe infections, physicians may need to administer medicines before bacterial culprit – and its potential resistance to antibiotics – is known. In such cases, combination antibiotic therapy (using more than one drug at a time) may be preferable to mono therapy (using one drug) because physicians need to maximize the chances that the organism is sensitive to at least one of them, Dr. Pop – Vicas said. Turning to treat an infection with inadequate therapy is associated with a worse outcome than using adequate therapy from the start, she added. Once drug resistant bacterium is known, treatment can be adjusted accordingly.
We need to learn more about ways to prevent the spread of multi drug resistance, said Dr. Pop-Vicas. What everyone wants to avoid is an infection with MDR bacteria resistant to all currently available antibiotics.
Founded in 1979, Clinical Infectious Diseases publish clinical articles twice monthly in a variety of areas of infectious disease, and is one of the most highly regarded journals in this specialty. It is published under the auspices of the Infectious Diseases Society of America (IDSA). Headquartered in Alexandria, Va., IDSA is a professional society representing about 8,000 physicians and scientists who specialize in infectious diseases. For more information, visit http://www.idsociety.org
What is an antibiotic?
An antibiotic is a substance that controls the growth of bacteria, either by killing them or inhibiting their ability to reproduce. They are used to treat bacterial infections, such as bacterial pneumonia, staph, and ear infections. Examples include bacitracin, cephradine, ciproﬂ oxacin (cipro), erythromycin, nystatin, penicillin, and tetracycline.
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The Rise Of The Super-Bugs,