Study Finds Hospital-Spread Germs Gaining Ground on Antibiotics With AM-Resistent
DANIEL Q. HANEY
Oct. 07, 1994
Study Finds Hospital-Spread Germs Gaining Ground on Antibiotics With AM-Resistent Germs-Washing
ORLANDO, Fla. (AP) _ Germs resistant to antibiotics are spreading at an alarming rate in hospitals, and doctors fear pneumonia, blood infections and other ills will become impervious to anything medicine can now throw at them.
If this happens, routine ailments can become killers, especially among those whose bodies are already weakened by disease.
Nowhere is this problem more urgent than in hospitals, where the spread of infections has always been a big problem.
About 85 percent of the types of bacteria responsible for hospital-acquired infections have gradually developed resistance to common antibiotics, said Dr. Martin Favero of the Centers for Disease Control and Prevention in Atlanta.
A study outlined Friday shows just how dramatically these medicines are losing their punch. Among the most worrisome problems is the emergence of common intestinal microbes called enterococci that are resistant to vancomycin, the main drug used against them.
Dr. Ronald N. Jones and others from the University of Iowa collected samples from 43 hospitals across the United States. They found that about 16 percent of enterococci can withstand vancomycin, and about half of these are also resistant to all the other primary antibiotics used against them - and even some drugs that have not been released yet for routine treatment.
Enterococci can cause life-threatening bloodstream and heart infections.
Of even more concern, however, is the possibility that enterococci might pass their resistance on to other nasty microbes, such as staph bacteria, that doctors now stop with vancomycin.
''This is a really terrifying potential,'' Jones said.
The survey also showed that 18 percent of pneumococci bacteria, which cause pneumonia, are resistant to penicillin. Two-thirds of one variety of staphylococcus bacteria were resistant to ciprofloxacin, another common antibiotic.
Jones presented his findings at an infectious-disease conference sponsored by the American Society of Microbiology.
Antibiotic resistance is almost as old as the antibiotic era, which began in the early 1940s with the discovery of penicillin. Within a few years, doctors witnessed the evolution of microbes that were impervious to the medicine.
Microbes acquire genes that shield them from the drug. This happens either through random genetic mutation or by picking up a resistance gene from another strain of bacteria.
Over time, the resistant bacteria become dominant as their susceptible kin are killed off by antibiotics.
Overuse of these powerful drugs is often blamed for resistance. Critics complain of a ''B-52 approach'' among some doctors who blitz their patients with a battery of broad-based antibiotics, often when they are unsure exactly what is making them sick.
However, in hospitals, poor hygiene also appears to play a role, and doctors and nurses are likely to be the carriers. Often they fail to wash their hands between each patient or after using the toilet.
''I've seen nurses disconnect tubing with their bare hands and reconnect them with subsequent infections,'' said Dr. Robert Weinstein of Michael Reese Hospital in Chicago. He said patients should demand that hospital workers wash up before seeing them.
Another way to fight the problem is simply to use antibiotics more sparingly.
Experts also suspect that the wide use of antibiotics in animal feed is contributing to resistance, although this has not been proved.
Doctors at the meeting suggested several possible ways of slowing down resistant germs. Among them:
-Consider prescribing common antibiotics for shorter periods of time.
-Use rapid diagnostic tests. Typically, doctors have to guess what germ is causing an illness. But new tests can pinpoint the microbe in minutes, allowing doctors to tailor treatment to the specific germ.
-Use antibiotic ointments, rather than pills, for skin conditions.
''There is no assurance that any of these means will stem the tide,'' said Dr. Gary Doern of the University of Massachusetts in Worcester. ''But they may be worth a try. We can hardly do any worse than we are right now.''