A common bacterium that is the leading cause of
hospital-related infections appears to be on the
brink of becoming an unstoppable germ.
Scientists with the U.S. Centers for Disease
Control and Prevention have confirmed that
Staphylococcus aureus, better known as a staph
infection, has for the first time defended itself from
the last remaining drug capable of killing all its
strains. The possibility of a widespread, untreatable
infection has not been known since penicillin
became widely used in the 1940s.
"We have a situation which is very worrisome,"
said Fred Tenover, a microbiologist who is
laboratory chief of the CDC's hospital infections
branch. He said that the newly isolated strain
demonstrated an "intermediate" level of resistance
to the last-line antibiotic, higher than any level
previously known for staph.
"If we're climbing the ladder," he said, "we're
almost to the roof."
Staphylococcus aureus, unlike other bacteria that
doctors fear might become unconquerable, often
lives peacefully with the human body. But it can
become a danger when it slips through an open
wound or sore. It is famous for causing not only
hospital infections but boils and even pimples.
Before the advent of antibiotics, a large enough
boil, for instance, could be fatal.
The newly discovered strain was found in a
Japanese infant who developed the infection after
heart surgery, Dr. Tenover said. The boy eventually
recovered with the aid of other drugs, but not
before doctors discovered that a staph-infected
abcess seemed to have some ability to resist the
drug vancomycin. The Japanese doctors sent
samples of the bacterium to Dr. Tenover for
examination.
Vancomycin, a powerful antibiotic, is considered
the last line of defense for some unusually stubborn
strains of staph and other bacteria. The drug has
been used for 30 years, and some doctors had
hoped that perhaps staph was not capable of
building a tolerance to it, said Dr. Robert Haley of
the University of Texas Southwestern Medical
Center at Dallas.
The fact that a patient was infected with even a
moderately resistant strain "means that we can
throw out the window the hope that Staph aureus
was not going to break through" medical defenses,
said Dr. Haley, former chief of the CDC's hospital
infections branch.
"I can't emphasize enough, this is a major turn for
the worse in the fight against infection," he said.
Penicillin, discovered in the 1920s, came to fame
after it successfully controlled staph in the 1940s.
But even the drug's discoverer, Alexander Fleming,
warned that resistance would surface after its
widespread use. In fact, by the 1950s, almost half
of all Staph aureus strains isolated had become
resistant to penicillin. Then in the 1960s, scientists
developed a new antibiotic called methicillin. But
by the late 1970s, methicillin-resistant staph had
become a growing problem.
Doctors were comforted, however, by the fact that
vancomycin was still there, still working.
"Vancomycin has been a silver bullet for staph," Dr.
Haley said.
The CDC is drafting new guidelines to control the
emergence of a possible vancomycin-resistant
strain, Dr. Tenover said. The guidelines are
scheduled to be published this summer in the
CDC's Morbidity and Mortality Weekly Report.
In addition, a discussion of the Japanese patient is
expected to appear in the July issue of the Journal
of Antimicrobial Chemotherapy.
Although the Japan incident represents the first
identified strain of intermediate-resistant staph,
other such strains may be out there, said Stuart
Levy of Tufts University in Boston, who is an
expert on antibiotic resistance.
"I would doubt that it's the only case," he said. "It's
a signal, it's an alert to hospitals all over the world
to look for these organisms."
He said the discovery of this strain could have
some benefit, if the finding warns medical workers
to take care to control its spread.
Dr. Tenover said he is concerned that staph might
follow the path of another hospital infection,
vancomycin-resistant enterococci, which also took
years to develop vancomycin resistance. In a short
time, it became a worldwide nuisance even though
enterococci had not previously been considered a
serious menace.
"Once it showed up, it spread like fire in a lot of
U.S. hospitals," Dr. Tenover said.
Given that history, scientists and public health
experts should develop a plan for the diligent
infection control, said Dr. Michael Edmond of the
Medical College of Virginia, who published a
strategy last year for controlling a
vancomycin-resistant strain of staph.
"Just because it's in Japan doesn't mean anything,"
Dr. Edmond said. "Whenever we talk about the
problem of antibiotic resistance, it's a global
problem."
He urged action even before a truly resistant staph
- one that would defeat all antibiotics - makes its
debut, an event many doctors consider inevitable.
"The emergence of vancomycin-resistant S. aureus
would represent the most important issue in
antibiotic resistance since the dawn of the antibiotic
era," Dr. Edmond and his colleagues warned last
year in the Annals of Internal Medicine. "A
common, virulent and transmissible bacterial agent
with no known effective therapy would set
infectious diseases back 60 years."
Something You Can Do About Drug-Resistant Bacteria. Note: Since this article first posted, the drug-resistant
strain has arrived in the US. -8/25/97
2/22/99
Lead in Calcium Supplements!
03:08 PM ET 01/27/97
Nutrition firm said to cut lead in calcium pills
WASHINGTON (Reuter) - A public interest group said Monday
that the country's largest maker of dietary calcium supplements
has agreed to reduce their lead content.
Expressing concern about the lead in the supplements, the
Natural Resources Defense Council also said it had petitioned
the Food and Drug Administration to set a standard to limit the
level of lead in calcium supplements and antacids.
But the National Osteoporosis Foundation said that while it
was concerned about lead intake, it nevertheless encouraged
people to continue taking calcium through their diets or, if
necessary, by supplements. Calcium combats osteoporosis, a
disorder in which bones become brittle and can fracture.
Defense Council senior scientist, Gina Solomon, said calcium
was needed as a dietary supplement, ``but to take calcium does
not mean consumers need to take lead in the process. Lead
presents especially high risks to pregnant and nursing women,
their unborn fetuses and young children.''
The council said it had sued Leiner Health Products Group
under a California law requiring a warning label on products
that expose users to more than 0.5 micrograms per day of lead.
Comment was not immediately available from the company.
It said Leiner agreed in a consent judgment that the
supplements it sells in California would fall under the 0.5
level by February 1. It added that the firm also sells the
supplements in other western states.
The council said in its petition to the FDA that studies
showed 22 major brands of calcium supplements and antacids
contain lead in excess of the 0.5 level and that technology was
available to produce virtually lead-free supplements.
11:04 PM ET 02/13/97
Key to long life is instant noodles - 103-year-old
HONG KONG, Feb 14 (Reuter) - Forget exotic foods such as
ginseng, shark's fin and bird's nest soup -- the secret of long
life is instant noodles, says a 103-year-old Hong Kong woman.
Lee Kok-fit told a banquet of 3,500 elderly, all aged over
73, that instant noodles were the staple that kept her going,
the South China Morning Post newspaper said on Friday.
Lee had been known to turn away many freshly cooked Chinese
dishes in favour of instant noodles, it said.
Many Chinese resort to obscure medicines or exotic foods to
promote long life. Thursday's annual gathering of the elderly
was to mark Yan Yat, the seventh day of the Lunar New Year.
^REUTER@
Study: Browned ground beef
no safeguard against E. coli
May 19, 1997
Web posted at: 10:36 p.m. EDT (0236 GMT)
From Correspondent Elizabeth
Cohen
(CNN) -- After the Jack in the
Box E. coli outbreak four years
ago, the United States
Department of Agriculture spread the word to cook hamburgers
thoroughly -- until brown in the middle.
But now studies indicate that a browned burger is not necessarily a
safe burger. At least that's what Melvin Hunt, a food scientist at
Kansas State University, concluded after extensive research on the
matter.
Hunt cooked ground beef and found that about 40 percent of the
burgers looked brown on the inside, but still hadn't reached the
temperature that kills E. coli.
"I really don't think that visual color is our best indicator of
doneness," Hunt said.
That's why Hunt doesn't like
campaigns like "Browny the Burger."
Browny is a creation of the Allegheny
County Health Department in
Pennsylvania. She tells kids to eat
only browned burgers.
And the USDA has a coloring book
that says: "Color the middle of the
hamburger brown then you'll know it's safe to eat."
The USDA also has delivered that message by distributing T-shirts
that read: "I would like a hamburger cooked until it's brown in the
middle."
Now, the USDA agrees that
Hunt's research is sound -- and
that the best way to test a burger
is to spend a few dollars on a
meat thermometer, something few
Americans are willing to do.
"We think that the message of
looking for the brown center is
helping the public. We think it may have saved lives, at least
prevented some illnesses," Kay Wachsmuth of the USDA said.
The USDA and the meat industry say another good sign for safe
burgers is to look for clear juices seeping from the meat.
But Hunt says that's not good enough. His solution: Do as he does
in the lab. Measure the temperature of the burger to ensure that it
is at least 160 degrees inside .
That may not be practical, but Hunt says it's a lot more reliable
than the eyeball method.
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