Posted on 04/20/2002 10:17:35 AM PDT by ex-Texan
Strep Bacteria Resist Antibiotics
April 19, 2002, 4:41 PM EDT
For the first time, doctors have documented a large-scale U.S. outbreak of antibiotic-resistant strep throat -- an episode involving at least 46 Pittsburgh schoolchildren.
Until now, antibiotics have easily killed group A streptococcus, the bacteria that cause strep throat and life-threatening septic infections, so doctors at Children's Hospital of Pittsburgh were startled by its sudden, widespread resistance to widely used erythromycin. The drug is commonly given to people allergic to penicillin and other patients.
Doctors suspect the strep bacteria also are becoming resistant to other popular drugs in the same antibiotic family, the macrolides. Their use is growing because they require only one dose a day, compared with three for many other antibiotics.
The jump in resistance began early last year at a Pittsburgh private school, where roughly half the strep throat cases were found to be untreatable with erythromycin. All the children were successfully treated with other drugs.
"It definitely went from one kid to another in the school and it also spilled over into the community," said lead researcher Dr. Judith M. Martin of the hospital's Division of Allergy, Immunology and Infectious Disease. "Where it started, I don't know."
The study was reported in Thursday's New England Journal of Medicine.
Dr. Chris Van Beneden, an epidemiologist at the Centers for Disease Control and Prevention, said the CDC will investigate.
"In may be occurring in other places across the country," she added.
Dr. Lincoln P. Miller, head of the Newark infectious disease outpatient clinic at University of Medicine and Dentistry of New Jersey, said the findings show doctors should limit use of all macrolide drugs.
"This is an important article because it indicates the impact of our antibiotic use on the bacteria around us," Miller said. "I would hazard a guess and say (this resistance is) fairly widespread."
Doctors have long warned that overuse of antibiotics is making some germs immune. Antibiotic resistance has been growing in another type of streptococcus that causes pneumonia, but a recent survey of half the states found that less than 3 percent of group A streptococcus samples were resistant to erythromycin and closely related azithromycin.
In 1998, Martin began tracking group A streptococcus at the private elementary school, taking thousands of twice-a-month throat cultures from children. In January 2001, the doctors began seeing many samples of the same group A strain resistant to erythromycin -- in all, 48 percent over that winter. Forty-six of the students had the antibiotic-resistant form of strep throat.
In addition, a random check of samples from children treated for throat infections at Children's Hospital found 38 percent had the identical resistant strain.
In an editorial, Dr. Pentti Huovinen of Finland's National Public Health Institute wrote that prevalence of group A streptococcus that cannot be treated by macrolide drugs began increasing in 1990. When regulations limited their use, the resistance problem dropped sharply.
* __
On the Net: http://www.nejm.com
National Institute of Allergy and Infectious Diseases:
http://www.niaid.nih.gov/dmid/antimicrob/
Copyright © 2002, The Associated Press
Frightening that it is breaking out in groups of small children. It may spread like wildfire. No pun intended. This may become a very scary disease outbreak.
Answer: Spontaneous evolution combined with industrial overuse of antibiotics at Western cattle feedlots, vast North Carolina hog farms, and those Delmarva Penisula poultry factories where the chickens never touch the ground during their entire lives.
Also, bacteria have an amazing ability to share new mutations by exchanging genetic materials, even between utterly alien species. Thus, resistance to an antibiotic can rapidly be transmitted to many different species.
Patent theft by government agencies (especially Canada and socialized Europe) have been drying up the research so that we are facing a critical loss of next generation antibiotics when the current armamentarium eventually fails (see the current NY Times).
IMHO Prediction? A major deadly world wide bacterial epidemic in the next 10 years, to make AIDS look like a piece of cake.
Well, aren't you the Suzy Sunshine!
Let's not forget the injudicious prescription of antibiotics by physicians when there is no need for an antibiotic, e.g. viral infections. Infectious disease physicians have been warning against this practice for at least 30 yrs. that I know of, yet the doctors keep handing out the prescriptions to keep the patient happy.
New drugs are there. The pharmecuticals want $$$ $$$ $$$
But it is a dangerous game as we have far gone out of the spectrum of basic penicillian.
Totally correct.
In some cultures (ie Haiti and Sicily) you haven't had a good doctor visit without an injection. This was how AIDS spread early on in Haiti, when gay infected sex workers passed the disease through unsterilized syringes in that benighted health care system.
Along the same lines, if prescription drugs for Medicare patients becomes law, it will have the unintended consequence of lowering the amount of money private drug companies can put into research. Not to mention the frivolous lawsuits over drugs like phen-fen which came with plenty of warnings at the time. Didn't the drug companies stop making childhood vaccines for the same reason? Not only will miracle drugs stop appearing on the market, chronic shortages will be the norm. Americans will reap what they sow.
I know it's popular to villify the evil pharmecutical companies--I'm not happy with the cost of medicine myself, but it costs somewhere in the area of $1 billion dollars to research, develop and market a new drug. Then the companies have to defend themselves from frivolous lawsuits which cost more millions in legal fees.
Simple economics tells us that, if the company is not going to make any money on the product, they really don't have any incentive to R&D another potentially life-saving drug.
Do you also blame the pharmaceuticals for developing such powerful agents that eventually lead to such deadly and drug-resistant bacterial infections?
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