Fw: Nightmare superbug is here, experts reveal

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----- Original Message -----

From: " Kathi " <pureheart@...>

Sent: Monday, July 08, 2002 4:06 PM

Subject: Nightmare superbug is here, experts reveal

> from J

> http://www.canoe.ca/LondonNews/lf.lf-07-08-0010.html

> Monday, July 8, 2002

> Nightmare superbug is here, experts reveal

>

> By HELEN BRANSWELL, CP

>

> TORONTO -- The nightmare superbug scenario has arrived.

>

> Medical experts have long feared the day when staphylococcus aureus,

> cause of some

> of humanity's most common and troublesome infections, becomes resistant

> to the

> antibiotic arsenal's weapon of last resort, vancomycin.

>

> The U.S. Centers for Disease Control has announced the first confirmed

> case of

> vancomycin-resistant staph aureus (VRSA) was found last month in a

> Michigan man.

>

> " The genie is out of the bottle, " says Dr. Low,

> microbiologist-in-chief at

> Toronto's Mount Sinai Hospital. " It's ominous. "

>

> The news leaves experts such as Low bleakly contemplating a future in

> which common

> staph aureus infections won't be treatable with antibiotics -- which was

> the case

> before penicillin changed modern medicine. Before penicillin, many

> now-routine

> surgeries were too dangerous because of the risk of infection.

>

> Penicillin is now nearly useless against staph aureus. Its overuse led

> to

> resistance, a process in which the rapidly evolving bug learns to evade

> the drug's

> firepower.

>

> Over the decades since antibiotics became a staple of medicine, bugs

> such as staph

> aureus and enterococcus have acquired resistance to a succession of

> antibiotics.

>

> Methicillin-resistant staph aureus (MRSA) and vancomycin-resistant

> enterococcus

> (VRE) are a fact of life in many hospitals.

>

> People who acquire antibiotic- resistant bugs generally pick them up in

> hospitals.

> But increasingly, these bugs are moving beyond hospitals.

>

> Experts and groups such as the Centers for Disease Control have been

> watching for a

> strain of staph aureus that resists vancomycin. Given the growing rates

> of

> methicillin-resistant staph aureus and the vancomycin-resistant

> enterococcus, it

> seemed inevitable.

>

> " It's only a matter of time before these two dance together in the right

> environment

> and this gene is shared, " Low said. " And this is exactly what's

> happened. "

>

> The gene Low referred to is the one that made enterococcus resistant to

> vancomycin.

> The interplay of the two bugs let the gene -- dubbed a " jumping gene " --

> leap from

> enterococcus to staph aureus.

>

> " It's not the totally resistant VRSA that we've been petrified of, " said

> Shirley

> Paton, Health Canada's chief of nosocomial (hospital acquired) and

> occupational

> infections.

>

> The Michigan man's infection responded to two new antibiotics, linezolid

> and

> quinupristin/dalfopristin. So his strain of staph aureus wasn't

> completely drug

> resistant. But those drugs are costly -- between $150 and $200 a day,

> versus $10 a

> day for vancomycin.

>

> And there have been reports of linezolid resistance in the U.S., one

> within a year

> of its introduction.

>

> The experts know the Michigan case is proof they will soon face a new

> nightmare --

> completely resistant staph aureus.

>

> " One could liken it to a ticking time bomb, " said Dr. Conly, who

> chairs the

> Canadian committee on antibiotic resistance and the University of

> Calgary's medical

> school. " The concern is -- is this going to spread from patient to

> patient? Is this

> just the beginning or the tip of the iceberg? Are we now going to see

> this spreading

> . . . (with) epidemics of surgical wound infections due to vancomycin

> resistance?

> Are we going to run into the scenario where we've got no options for

> treatment of

> these patients? "

>

> Some of those questions may be answered in October, when a major

> national policy

> conference on antibiotic resistance is held in Ottawa.

>

> " I think it will really focus and crystallize attention on this issue, "

> Conly said.

> " With the advent and arrival of VRSA, I think this appears to be a very

> timely

> meeting. "

>

> In the meantime, Health Canada will speed up production of guidelines to

> help

> hospitals control vancomycin-resistant staph aureus, Paton said.

>

> The plan will spell out how patients with the superbug are to be

> isolated, which

> public health authorities must be notified and how labs must gear up to

> recognize

> it.

>

> " We want to be able to put walls around the organism as best we can to

> keep it from

> spreading, " she said.

>

>

>

>

>