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.”

FoxNews

How Using Antibiotics in Animal Feed Creates Superbugs

How Using Antibiotics in Animal Feed Creates Superbugs

Many livestock groups say there's no evidence that antibiotics in livestock feed have caused a human health problem, but researchers beg to differ.

Researchers have nailed down something scientists, government officials and agribusiness proponents have argued about for years: whether antibiotics in livestock feed give rise to antibiotic-resistant germs that can threaten humans.

A study in the journal mBio, published by the American Society for Microbiology, shows how an antibiotic-susceptible staph germ passed from humans into pigs, where it became resistant to the antibiotics tetracycline and methicillin. And then the antibiotic-resistant staph learned to jump back into humans.

"It's like watching the birth of a superbug," says Lance Price of the Translational Genomics Research Institute, or TGen, in Flagstaff, Ariz.

Price and colleagues in 19 countries did whole-genome analysis on a staph strain called CC398 and 88 closely related variations. CC398 is a so-called MRSA, or methicillin-resistant Staphylococcus aureus, that emerged within the past decade in pigs and has since spread widely in cattle and poultry as well as pigs.

The genetic analysis allowed the study authors to trace the lineage of the livestock bug back to its antibiotic-susceptible human ancestors. Price says it shows beyond a doubt that the animal bacterium jumped back into humans with close exposure to livestock.

This "pig MRSA" has been detected in nearly half of all meat sampled in U.S. commerce, according to the American Society for Microbiology. Most staph found in meat can be eliminated by cooking food well, but it can still pose a risk to consumers if handled unsafely or if it cross-contaminates with other things in the kitchen.

Price told The Salt that the new resistant human bug appears to be spreading beyond people with direct exposure to livestock.

"Initially we could always trace it back to livestock exposure," Price says. "But now we are starting to see cases of resistant strains that we can't trace back. So we think it may be changing gears, so to speak, and gaining the capacity to be passed from person to person."

Price says the new data provide an early warning of what might become a major public health problem.

"We're seeing this one coming," he says. "The question is how often will this occur in the future if we don't start controlling antibiotic use?"

So far, the proportion of human MRSA infections due to this livestock-derived strain is small. But in some areas of the Netherlands, it's causing as many as 1 in 4 human MRSA cases — suggesting that it has the potential to spread extensively.

Paul Keim, another study author, says the report shows that "our inappropriate use of antibiotics ... is now coming back to haunt us." He says the solution is clear — banning antibiotics in livestock feed, as the European Union has done.

Most antibiotics sold in the U.S. go to animals, mostly in their feed, where they act as a growth promoter and damp down infection outbreaks in large feedlots.

Many livestock groups say there's no evidence that using antibiotics in livestock feed creates a human health problem.

"Most informed scientists and public health professionals acknowledge that the problem of antibiotic resistance in humans is overwhelmingly an issue related to human antibiotic use," the American Meat Institute says.

The new report adds fuel to the long-running debate about antibiotic use for livestock, and the government's responsibility to regulate it. In December, the FDA withdrew a 1977 proposal to remove approvals for two antibiotics, penicillins and tetracyclines, used in livestock and poultry feed. It said it would focus instead on "voluntary reform" by the meat industry to limit use.

Then in a partial reversal in January, the agency said it would ban one class of antibiotics called cephalosporins from animal feed.

NPR