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
Animals are given a vast spectrum of antibiotcs, not just erythromicin.
And to make matters more complicated, sometimes mutations with new immunity to a particular antibiotic (say by creation of stronger cell wall) can also convey immunity to other, different antibiotics.
That is exactly the way a strep throat should be treated, but in studies I did in the hospital setting, a very small percentage of doctors did this. Most just handed out the strongest available antibiotic (called shotgun therapy) and hoped for the best. They frequently didn't even know for a fact that the patient had a strep throat.
I couldn't say.
I'm too busy washing and washing my hands.
SO TRUE--I have family who are farmers. I can't begin to remember the drugs they told me that the animals were injected with as soon as they were born. Not to mention the fact that they are now using antibiotics as a growth factor.
Yes and the animals are give vast amounts of hormones. There are many effects which will not be known for generations. I've read theories claiming that these hormones in meat and poultry cause everthing from the increase in certain types of cancer, the increase in homosexuality, and the steady lowering of the age of onset of menses in young girls. Who knows?
A culture is important but with it they should also do a "sensitivity" test where they expose the cultured organism to a number of antibiotics to see exactly what the organism is going to respond to. Otherwise, you are wasting time, money and again helping to create more disease resistant bacteria--not to forget that the patient is not getting better.
I'm sorry, that's what I was referring to as not having been done.
As my previous posts would indicate, I am against the indicriminate use of antibiotics for every little sniffle. However, a strep throat needs to be treated with the proper antibiotic therapy.
The patient may well recover on their own, however the antibodies that the immune system develops to fight the disease can attack the heart and cause serious problems. No strep throat should go untreated.
34...Laudable--I guess not--however this is a capitalist economy and I don't know any business who is producing a product or providing a service that is doing it out of a sense of charity. All of the major developments in pharmaceuticals have come from the US because there is a profit motive--unlike our socialist friends...(scholar)
Everyone does NOT agree. Scholar, do not let him use guilt to force you into a position you do not agree with. The Westerner speaks as if he should have the right to determine how much profit is allowed and people exist to serve him in his time of need. That is the way it works in socialism/communism. It is not the way our society works.
People produce a commodity or service because they have a talent and there is a demand for what they produce. If they have no talent they get nothing. If there is no demand they get nothing. The value is determined in willing exchange between the buyer and the seller. No one else has a right to intervene. No one has a right to force the seller to sell or set the price. What makes anyone think they have the right to the talents of another? If they have a right doesn't that make the producer a slave?
The goal is not profit. Profit is the means. It is the means to a better standard of living. It is the means to achieve goals and dreams.
Exactly! Please check my post at #17 where I pointed out the astronomical expense of researching and developing a new drug. The socialist societies who are trying to get something for nothing are getting just that--nothing.
Good docs!! I think the medical community is begining to police itself..I have to tell you though even most bacterial infections will self resolve if well treated. It is the resistance of bacteria that is an issue .I think part of the problem is working moms need the kids well as soon as possible.
I have Asthma, a cold is a serious thing for me.I have taken more antibiotics in the last five years than in my entire life before:>). But I always try natural remedies first..
I have to tell you that most of my kids only took antibiotics once or twice in their lives..today they are all very healthy adults..I have a 39 year old son that missed his first day of work last year..They have awesome immune systems.
It takes wisdom with the kids..too much is bad and too little could be deadly..so good doctors are essential..yours sound good!
HIV = Immunocompromised ????
HIV patients are not the only ones who are immunocompromised. All patients on cancer chemotherapy are immunocompromised due to their chemotherapy drugs. There are more but I'm too lazy to pick up my books a find out which ones.
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