Superbugs: Dangerous New Strains That Evade Antibiotics

11:43 PM, Mar 1, 2013   |    comments
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WALDORF, Md. (WUSA)-- The emergence of superbugs has been in the news, especially the spread of powerful new strains that can't be cured by even antibiotics of last resort. Critical care specialists like Dr. Henry Mansur at the NIH Clinical Center are particularly concerned with CRE's (carbapenem-resistant Enterobacteriaceae), a family of germs that have become particularly deadly and difficult to eradicate.

CRE's often strike already immune-compromised people in hospitals and nursing homes.  Dr. Masur says, "The CRE's are very dangerous as they attack our most vulnerable patients and we have almost no active antibiotics against this organism. Globally, and in the US, we overuse antibiotics in humans and agricultural animals and our antibiotics are getting less and less potent. There is a crisis because we desperately need to have better stewardship of them which means using these only in human when necessary.  If overused, we won't have them available when we do need them."

While CRE's are typically encountered in the healthcare setting, other resistant bacteria have moved out into the community, including MRSA (Methicillin-resistant Staphylococcus aureus) The bacteria can live harmlessly on a person's skin or in the nostrils; however, if it enters the body through an open wound or invasive device (such as a catheter) it can cause devastating infections, such as the one encountered by Kerri Cardello, 42,  of Waldorf, Maryland. 

She became very ill around Christmas time in 2003, a week after she was treated for a broken nose.  That may have been when she was exposed to MRSA, but doctors still aren't sure of its origin.

Cardello became feverish and seriously ill.  She says she visited the emergency departments of two hospitals, and was sent home with the diagnosis of flu, with symptoms that continued to get worse.

Cardello remembers, "I couldn't breathe and I looked in the mirror and was a grayish color."

Cardello finally called 911, and was brought back to the hospital. Pneumonia was shutting down her lungs, and doctors couldn't fight it. Finally, she was transferred to Johns Hopkins Hospital in Baltimore, where she got the right diagnosis: MRSA.

Cardello was in a medically induced coma for months as doctors tried to contain the infection.  Eventually, it caused gangrene in her legs, and Cardello was awakened by her aunt to give consent for amputation.

"She pulled the covers back and said, 'What do you think?'  And I was like - take them, just take them."

Ramanan Laxminarayan, PhD studies drug resistance with the Center for Disease Dynamics. He says the scope of MRSA's spread is frightening.

"Twelve years ago, MRSA was never transmitted outside of the hospital," says Laxminarayan. "Now it's a phenomena. You can pick up the bug at a gym locker because these super bugs change over time."

"The doomsday scenario is not going to arrive all in one day, it is going to happen progressively. But just the fact that today we cannot treat patients with infections that just ten years ago could be easily treated, should be quite a shocking revelation."

The NIH's Dr. Masur agrees, "Overuse clearly limits the shelf-life of lifesaving drugs."

Both men say another part of the problem is the lack of new antibiotics in the pharmacopeial pipeline.  The drug industry agrees that new infection fighters are badly needed, and says it is working with the FDA to streamline the approval process for new drugs that fight increasingly resistant infections. 

Dr. Masur says, "We need incentives for these companies to make these lifesaving drugs. If these companies don't take advantage of federal government research advances, we won't have the drugs that help us when we and our loved ones have life-threatening infections."

Kerrie Cardello is grateful to have survived her superbug infection.  After months of rehabilitation, she was finally able to come back home and resume life with prosthetic legs.  Now she educates others about MRSA, and tries to be the best possible mother to her four children.

Cardello says, "They deal with it every day still. They worry... is mom OK? Is she sick today? Things most kids just don't worry about."

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