What hath man wrought?
The Centers for Disease Control
(CDC) scientists determined that a new strain of multidrug-resistant
Salmonella, passed from cows to humans through milk, cannot
be controlled by antibiotics.
In 1989, staphylococcus infections
were relatively unknown to hospitals. By 2002, nearly two-thirds
of all hospital infections were attributed to antibiotic-resistant
staph infections. This bacteria has been attributed to a
new genetically engineered version of staph, a superbug
inadvertently produced by Monsantos Bovine Growth
Resistance is Growing in Scope
Jia-Rui Chong, Times Staff Writer
February 26, 2006
staph germ once largely confined to hospitals is
emerging in jails, gyms and schools
It all began
with what looked like a spider bite on Eileen Moore's left thigh.
Nothing to worry about, she figured.
Within 24 hours,
the "bite" became a 6-inch welt with a bubble of pus that
eventually ripened into a black wound. Over the next few months,
scabs dotted her face. A hangnail caused her middle finger to bloat
like a sausage. Her pierced ears oozed pus.
The cause of
Moore's ordeal was a bacterium known as methicillin-resistant Staphylococcus
aureus, which in its most severe form can turn into a fatal flesh-destroying
the infections were found only in hospitals, where the constant
use of different antibiotics, including the potent methicillin,
made it resistant to many of the most powerful antibiotics.
In the last
few years, it has emerged in gyms, jails, schools - and just about
anywhere bacteria can grow. It has become a simmering problem that
is largely unknown by the general population.
characterize it as widespread, and in some areas it is epidemic,"
said Jeff Hageman, an epidemiologist at the Centers for Disease
Control and Prevention and a coauthor of two studies on staph published
There are few
statistics on the disease, because resistant staph infections are
not routinely reported to the CDC. But one study published last
year in the journal Emerging Infectious Diseases estimated there
were about 126,000 cases from 1999 to 2000 - twice the number of
hepatitis B cases each year.
with which this has emerged over the last two to three years is
probably unprecedented," said Donald Low, a microbiologist
at the University of Toronto who was one of the key scientists who
dealt with Toronto's SARS outbreak in 2003. "When you look
at the numbers, this way outstrips other so-called new infectious
players with the St. Louis Rams developed lesions on their elbows,
forearms or knees, where turf burns had opened up their skin in
2003. Players from a competing team also developed sores after playing
against the Rams.
has seen a surge of this antibiotic-resistant bacteria in intravenous
drug users and homeless people.
In 2004, actress
Hilary Swank found a blister on her foot while training at a Brooklyn
boxing gym for her part in the film "Million Dollar Baby."
It turned out to be a staph infection.
Moore, a 38-year-old
La Canada Flintridge software consultant, has no idea where she
got her infection. All she knows is that it took four debilitating
months with three increasingly powerful antibiotics to rid herself
of the disease.
she views every rash and pimple with suspicion.
germophobe now," she said.
A large part
of the problem in combating the staph bacterium is that it is everywhere.
More than 30%
of Americans carry some kind of staph infection in their nose. About
1% have the methicillin-resistant strain, and half of those have
an even newer strain that is less resistant, but more damaging.
Many carriers never develop a skin infection, either because they
have some unknown immunity or because the bacteria never have an
opportunity to penetrate their skin through a wound or rash. But
carriers can still spread the disease.
aureus was first identified in the 1880s. It was named aureus, or
golden in Latin, because of its distinctive color.
as a relatively undistinguished microbe until the mid-20th century.
The introduction of the first antibiotic, penicillin, in 1941 set
the bacterium on its deadly journey of mutation. It took just two
years for reports to trickle in of the bacterium's resistance.
In the early
1960s, doctors deployed a new antibiotic, methicillin, against the
disease. The first signs of resistance appeared in less than a year.
strain became ingrained in hospitals in Europe, Australia and the
By the early
1990s, methicillin-resistant staph infections became the leading
cause of hospital-acquired skin infections in the U.S. Recent studies
have shown that this kind of staph bacterium has also colonized
hospitals in Egypt, Taiwan and South America.
It was inevitable
that the resistant bacterium would emerge elsewhere.
The first smattering
of cases of what came to be known as community-acquired methicillin-resistant
Staphylococcus aureus appeared as early as 1990.
strain is genetically different from that found in hospitals. Because
it has not been bombarded by as many antibiotics, it is less resistant
to drugs, but is more virulent.
To gauge the
prevalence of the strain, researchers at Olive View-UCLA Medical
Center in Sylmar analyzed skin infections that showed up in their
emergency room. In 2002, methicillin-resistant staph caused 29%
of those infections. Two years later, the rate was 64%.
A study published
last year in the New England Journal of Medicine estimated there
were about 26 community-acquired cases per 100,000 people in Atlanta
and 18 per 100,000 people in Baltimore.
It is a hardy
bug. The bacterium likes to grow in warm, moist areas of the human
body, such as the nose, armpit or groin. It can linger on the skin
without causing infection, waiting to enter through a cut or an
abrasion. Unlike many other germs, it can also survive hours, possibly
days, on inanimate objects such as towels or catheters.
the body, the bacteria can bloom into rashes, pimples and boils.
But sometimes the bacteria cause invasive infections, such as pneumonia
or meningitis. In a few cases, staph infections can turn into a
nightmarish necrotizing fasciitis, the so-called flesh-eating disease.
In rare cases, an infection can be fatal.
Lancing a wound
is sometimes enough to stop a broader infection. But if the bacteria
has spread through a person's body, antibiotics are the only effective
There is a hierarchy
of antibiotics, starting with older drugs, such as penicillin, and
working up to the most aggressive ones, including vancomycin and
linezolid, which can cause serious side effects. Using the most
aggressive ones first only helps to foster more drug resistance.
Thus, infected patients are often initially prescribed antibiotics
that have little effect.
Lovato's 9-year-old daughter, Cynthia, developed tiny red bumps
on her hips and abdomen in August, her pediatrician thought the
young girl had flea bites.
prescribed the common antibiotic amoxicillin, but the boils didn't
go away, said Lovato, a 38-year-old air conditioner repairman from
San Jose. He tried to help his daughter by popping them.
Soon he spotted
a pimple on his own neck that looked like an ingrown hair follicle.
Within days it grew to the size of a quarter. Then a painful rash
10 inches wide erupted on his groin, he said. Another popped up
on his chin.
In about a week,
he developed a fever and went to the local emergency room, where
doctors cut open the wound on his groin and prescribed amoxicillin,
By the beginning
of September, their boils were growing faster than they had before
and were three times bigger. Cynthia would scream when anyone touched
them. Pus started coming out from beneath Lovato's fingernails.
His 3-month-old son, Hayden, developed small bumps on the back of
his head, Lovato recalled.
The whole family
went back to the emergency room and the doctor prescribed different
antibiotics, including rifampin, a drug commonly used to treat tuberculosis
and leprosy, but which can cause liver damage.
They went on
a mission to try to contain the infection. They wore surgical gloves
when they tended their sores. They squirted sanitizer gel on their
hands every time they touched anything. They scrubbed walls, doorknobs
and surfaces with bleach and washed their bedding in hot water every
other day. They skipped work and school for months, sequestered
in their bedroom with little contact with the outside world, he
For the last
month, they think they've been clear. But they fear the infections
trying to be optimistic," said Lovato's wife, Lorraine, the
only one to escape infection.
Amid the din
of afternoon wrestling practice at Bell High School, 14-year-old
Manuel Villegas pushed a microfiber mop infused with a disinfectant
across purple gym mats.
going to get it," Villegas said. "That's why I take two
showers a day, before practice and after practice. I bring my own
soap to the boy's locker room."
popping up on Coach Eric Klein's wrestlers about two years ago,
and Klein quickly invested in the $200 mop. He didn't know exactly
what was causing all of the rashes - maybe ringworm, maybe staph
- but he was worried.
he started asking the kids to lather themselves in a special wrestling
foam that is supposed to provide a barrier to transmission.
a lot of money on having the mats cleaned," Klein said. "The
last couple or three years, it's been a big stress."
A large part
of the problem with the spread of drug-resistant staph is that it
is difficult to diagnose. The only way to tell for sure is a test
that can take up to three days for results.
the La Cañada resident, started on the common antibiotic
Keflex and ended with rifampin.
think how I have something that's resistant to all Western medicine,
or almost all Western medicine, that's scary to think about,"
Moore said. "Had I been resistant to those other antibiotics,
I could have died."
Dr. Thomas Horowitz,
who treated Moore at his office in downtown Los Angeles, said if
rifampin didn't work, he was prepared to check her into the hospital
and set up an intravenous drip of vancomycin, considered one of
the antibiotics of last resort.
seeing resistance to so many of the antibiotics, and so little new
antibiotic research is going on," Horowitz said.
Ten years ago,
a strain that could partially resist vancomycin surfaced in Japan.
A totally resistant
strain emerged a few years later in Michigan. Doctors have recorded
six cases worldwide, all in the U.S.
Within a few
years of the introduction of penicillin in 1941, antibiotic-resistant
forms of Staphylococcus aureus began to appear. These bacteria,
once found only in hospitals, have now emerged in the general population.
Scottish surgeon Alexander Ogston identifies a bacterium, Staphylococcus
scientist Alexander Fleming discovers the first antibiotic, penicillin.
becomes available in the United States and England. The first penicillin-resistant
Staphylococcus aureus is reported a short time later.
one-quarter of Staphylococcus aureus bacteria in hospitals are penicillin-resistant.
still considered an antibiotic of last resort, is introduced.
1959: The antibiotic
methicillin is introduced.
find the first cases of methicillin-resistant Staphylococcus aureus.
find vancomycin-resistant Staphylococcus aureus in the United States.
95% of Staphylococcus aureus worldwide is penicillin-resistant and
60% is methicillin-resistant.
Food and Drug Administration, Princeton University, Chemical Heritage
Foundation, National Academy of Sciences, ActionBioscience.org
Antibiotic Resistant Pathogens
in What We Eat
Staphylococcus aureus (MRSA) infection is caused by a strain
of staph bacteria that's become resistant to the antibiotics
commonly used to treat ordinary staph infections such as
According to the World Health
Organization, "About 75% of the new diseases that have
affected humans over the past 10 years have been caused
by pathogens originating from an animal or from products
of animal origin. Many of these diseases have the potential
to spread through various means over long distances and
to become global problems."
The June, 2011 issue of Zoonoses
Public Health (2011 Jun;58(4):252-61) will include a
study in which milk from three herds of European dairy cows
was tested for antibiotic-resistant Staphylococcus aureus
bacteria (MRSA). The researchers determined, "...in
all three herds, MRSA of spa-type t011 were detected in
milk samples. Results show that MRSA of spa-type t011 is
a problem in dairy farms that needs
to Have the BEST Odds of Avoiding Degenerative Disease
to list of Articles