Posted on 09/29/2002 4:45:10 AM PDT by blam
Amazon advocate warns of 'superbugs'
September 27 2002 at 08:47AM
By Maggie Fox
Washington - It was reported on July 5 - no surprise to doctors but an unpleasant revelation nonetheless - that a patient was infected with a bacteria that shrugged off vancomycin, the "antibiotic of last resort".
It was the first case of vancomycin-resistant Staphylococcus aureus in the United States.
Called VRSA for short, this bacteria was a real "superbug", oblivious to virtually all antibiotics on the market. It is a real-life example of how the over use and abuse of antibiotics has diminished the power of what once were wonder drugs.
The over use and abuse of antibiotics is helping the bacteria The patient, a 40-year-old Michigan man with diabetes, seems to have caught the bug from an infected catheter inserted while he was in the hospital for the amputation of a gangrenous toe - a common complication of diabetes.
The man already had methicillin-resistant S. aureus and the cocktail of antibiotics he was given had seemed to be working.
But, as is happening to more patients on extended hospital stays, the bacteria in his body mutated so that they came to resist the antibiotic of last resort - vancomycin.
Luckily, other, older antibiotics worked, and bacteria from the patient's body also seemed susceptible to the newest antibiotics on the market, at least in the test tube.
The case illustrates in real-life horror what scientists have been warning about for years - the over use and abuse of antibiotics is helping the bacteria they fight to become stronger, fitter and, eventually, to become invincible.
'I don't use antibacterial soaps' After 20 years of complacency, during which the medical establishment believed the arsenal of antibiotics was more than enough to battle any infection that the microscopic world could throw at mankind, drug companies are once again searching frantically for new sources of antibiotics.
This should please Amazon activist Mark Plotkin, whose book Medicine Quest made the case that in destroying the primeval rain forest, humankind could lose a key source of medicines that might cure a range of ills from cancer to super bugs.
But it doesn't please him.
"I really got into the drug-resistant bacteria stuff and the more I read it, the more scared I got," Plotkin, whose latest book published this month, The Killers Within, outlines "the deadly rise of drug-resistant bacteria".
"The bugs are getting stronger and they are getting stronger faster. What is causing this? The abuse of Mother Nature's greatest gifts," said Plotkin.
Plotkin, who wears a necklace made of Amazonian seeds over his button-down cotton shirt, has met and studied with shamans whose knowledge of plants, he says, may offer a host of cures to medical science.
Plotkin's Amazon Conservation Team looks for any angle it can to preserve the forest and the way of life of Amazonian indigenous peoples. He not only pushes the idea of saving lives by saving pristine forest - he has helped tribes map their territories so they can make legal claim to them.
So it would be natural to think his book, written with journalist Mark Shnayerson, would expound on how the cure to the super bugs lies in this barely mapped forest.
But he never says that, even though many modern antibiotics come from plants and bottles of dirt from undeveloped lands. Vancomycin, for instance, was first purified from a soil sample sent to a pharmaceutical company by a missionary in Indonesia, according to Plotkin's book.
"I don't have any blockbuster drugs from plants that can cure drug-resistant infections," he said. "There is no one magic bullet."
Penicillin, the mother of all antibiotics, comes from mould and it stands to reason, said Plotkin, that plants would have natural microbe-killers.
"You realise that of course plants have to protect themselves against infection and of course plants produce antibiotics," he said. "Nature holds the answer. What we are looking at is a search for new antibiotics."
Plotkin believes, of course, this means looking to the Amazon. "The bacteria are moving and we are not developing new antibiotics. There is very little in the pipeline," he said.
But Plotkin, an ethnobotanist, is vocal in his belief that a search of the world's rain forests for new antibiotics to zap the mutant bacteria is only part of the answer.
"We need to out-think them," he said.
That means following the advice of experts who have been nagging doctors for years to stop prescribing antibiotics for patients who have viral infections - no matter how much those patients nag, beg and wheedle.
Antibiotics are useless against viruses and the more the body's natural populations of bacteria are exposed to them, the more likely they are to evolve into forms that resist them.
This happens through natural evolution.
Bacteria that are fully susceptible to a drug are quickly killed by it. But a few variants will be less susceptible. They survive, multiply, and pass on the genes that gave them resistance.
Unless these intermediate forms of bacteria can be killed, the process will continue until a true super bug develops. When that patient really needs an antibiotic, it may not work.
Worse, the patient can pass on his or her newly pumped-up bacteria to children or elderly relatives whose bodies are less able to fight them off.
Dr Paul Offit of the Children's Hospital in Philadelphia, one of America's experts on infectious diseases, knows what that can mean. He had one such child under his care die.
"The feeling that you have when you stand by the bed of a patient like this is absolute helplessness," said Offit.
"I felt what it was like back in the 1930s, before antibiotics. We were trying to wash her skin with an acid-like vinegar, to kill the bacteria. It was that pathetic. And she died in a manner that was like falling off a cliff in slow motion. It was unstoppable."
To experts like Offit the answer is clear. Doctors have to be more judicious in their use of antibiotics, patients have to take them correctly, and new antibiotics need to be created.
Doctors and patients alike must understand that no antibiotic will offer the ultimate answer. Bacteria evolve in the blinking of an eye. They swap genes that give them shortcuts to overcome even the most cleverly designed drugs N and they have survived for 3.5 billion years.
Humankind is foolish to believe it will be easy to vanquish such an ancient and hardy life form.
Plotkin advises some everyday measures, as well.
"I don't use antibacterial soaps. Why throw the heavy artillery when you don't need it?" he said.
The US Food and Drug Administration took some action this month, as well, issuing guidelines on how to determine whether using new antibiotic drugs in livestock is likely to lead to drug-resistant disease in the humans who eat them.
For years farmers have given low doses of antibiotics to their animals because they grow better. But Plotkin agrees with experts who say this is courting disaster.
"Feeding animals sub-clinical doses of antibiotics seems to be the perfect experiment to create resistance," he said.
I read your title and wondered what Amazon was talking about "superbig".
Staggers the imagination, eh? ;-)
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