The layperson's guide to antibiotics. What they are, how they work, when they will not work, Extended information and links.
Thursday, September 20, 2012
Deadly 'superbugs' on the rise: What you need to know
Deadly 'superbugs' on the rise: What you need to know
Concern has been raised once again over the threat of deadly ‘superbugs,’ after a seventh individual at the National Institutes of Health Clinical Center in Bethesda, Md., died Friday after contracting an antibiotic-resistant strain of bacteria.
According to the Washington Post, the boy from Minnesota contracted the bug while being treated at the hospital for complications from a bone marrow transplant. So far, he is the 19th patient at the NIH center to have contracted the bacteria – Klebsiella pneumoniae carbapenemase (KPC). The bug’s outbreak was traced back to a single patient who was carrying the bacteria when he was admitted to the hospital in the summer of 2011.
While the NIH declined to be interviewed on the matter, the agency released a statement about the incident.
“We are deeply saddened by the deaths at the NIH Clinical Center related to [KPC],” the NIH said in a statement. “The health and welfare of patients is NIH's top priority, and NIH has – and will continue to – take every measure possible to protect patients at the Clinical Center and quell transmission.”
The NIH went on to add that “the Clinical Center is taking strong action to keep KPC from spreading further, redoubling its efforts to ensure that all the infection control and isolation strategies recommended by the Centers for Disease Control and Prevention (CDC) are followed stringently.” They agency is also continuing to test for KPC and amp up their de-contamination procedures.
This latest death raises serious questions about the rise of bugs no longer treatable with antibiotics. The emergence of antibiotic-resistant strains of bacteria has become a recent dilemma in the past few years. A notable example has been the rise of the “staph” germ known as MRSA - methicillin-resistant Staphylococcus aureus – which caused unease after the CDC reported 18,650 American deaths from MRSA in 2005.
According to infectious disease experts, both MRSA and KPC are results of the same problem – the overuse of antibiotics. Utilized in livestock feed, by medical professionals and by consumers just to treat the common cold, the abundance of antibiotics in our society has prompted evolution to select for the antibiotic-resistant trait.
“Bacteria are becoming more and more resistant as more and more antibiotics are being used – and they’re becoming smarter,” Dr. Joseph Rahimian, an infectious disease specialist at Village Park Medical in New York City, told FoxNews.com. “….There are limited choices for treatment. Only a few antibiotics work in that scenario, and they’re typically antibiotics we don’t frequently use – some affect the kidney, some aren’t readily available, and some don’t lead to [good] blood levels.”
What is KPC?
K. pneumonia is an organism that lives in the large bowel, which can cause the disease Klebsiella pneumonia – a condition marked by high fever, chills and the expulsion of a thick, viscous fluid called sputum from the lungs. To combat K. pneumonia, a class of antibiotics called Carbapenems is used; however, when the organism becomes resistant to Carbpaenems, it becomes known as Klebsiella pneumoniae carbapenemase.
Rahimian noted KPC is one of the more dangerous strains of antibiotic-resistant bacteria. Unlike MRSA – which has some other treatment options apart from antibiotics – KPC has very few options, making it much more difficult to combat.
The people most susceptible to contracting KPC are those who are critically ill or who have a weakened immune system, which is why outbreaks easily occur in hospitals. Although most of the cases have occurred at the NIH Clinical Center, all hospitals in the Northeast and beyond should be on the lookout for outbreaks of this kind.
“Since the 1990s, some drug resistant isolates of KPC have emerged,” Dr. Amy Ray, an infectious disease expert with UH Case Medical Center in Cleveland, Ohio, told FoxNews.com. “And certainly the Northeast has been a focus of concern, but no hospital in the United States is immune to KPC. In fact, the organism and KPC producing organism have been described worldwide – in Europe, Asia and South America.”
KPC spreads through direct contact of the skin, which can eventually lead to infection. According to Rahimian, a person can also be a carrier of the bacteria and not show any symptoms.
What you can do
“Unfortunately there’s not a lot you can do as a patient,” Rahimian said. “If other people are using unnecessary antibiotics, they are promoting the development of resistance, [which] might affect you even though you didn’t do anything.”
Because of its difficulty to identify and treat, both Rahimian and Ray say that prevention is key to combating KPC and other antibiotic-resistant bugs.
“The single biggest effort the hospitals can undertake is to ensure that their infection control and prevention departments are up to date,” Ray said. “Also that they are tracking and trending organisms such as these to understand their local epidemiology. And at the single health care worker level, the most important thing is hand hygiene and the use of standard precautions to prevent the transmission from person to person.”
For the average individual, taking proper precautions – such as thoroughly washing their hands and making sure their doctors are doing the same – is crucial.
Going beyond these anti-infection measures, many health care professionals and others are calling for more judicious use of antibiotics, in hopes to stop the emergence of antibiotic resistance. Numerous ‘antibiotic stewardship’ campaigns are in effect to stop people from taking or prescribing antibiotics when they are not truly necessary.
As far as research goes to develop smarter drugs to combat KPC, experts agree that funding and focus are lacking – meaning proper treatments may not be available for some time.
“We are facing a critical shortage of anti-microbial agents,” Ray said. “The field is desperate for drug discovery.”