Resistant Infections: No Minor Nuisance
by Thomas Murray
We’ve
all been shocked by the occasional news stories about the dreaded
flesh-eating bacteria. With so many negative stories in the news,
it’s easy to convince yourself, “that
could never happen to me.” However, even the most common hospital infections
like staphylococcus, once considered a minor nuisance easily cured by antibiotics
like methicillin, have begun to show an increased resistance to the latest medications.
In 2002, doctors in Geneva first confirmed Methicillin-resistant
Staphylococcus aureus or MRSA, the most common hospital infection
in the world. Bacteria with drug resistance can, as their name implies,
resist standard courses of treatment with even the strongest antibiotics,
spreading from the site of infection through the bloodstream, causing
system-wide infections.
However, these persistent infections eventually succumb to treatment,
but it is often in longer-than-recommended courses of medicines.
Unfortunately, with such treatment, the drugs are so potent they
make the patient sick. As a last resort, surgical removal of the
infected tissue or amputation is the only effective treatment.
Until a few years ago,
such super-bugs were thought contained to hospitals. However, an
article in the January edition of Environmental Health Perspectives
medical journal proves that sterilization procedures in hospitals
along with proper sanitation and advanced medicines are no longer “silver
bullets” against
the spread of these insidious maladies into the general population.
Research published in
the Journal of the American Medical Association further indicates
that outbreaks of tuberculosis and Legionnaire’s
infections have shown signs of flourishing outside of hospitals and
in much more public settings like restaurants and office buildings.
As a high profile example, when word broke in October 2003 that the “Man
of Steel” Christopher Reeve, passed away “from complications
arising from an infection,” few in mainstream America realized
his disability had not contributed directly to his death. However,
when pressure sores due to immobility or the use of prosthetics threaten
to kill you, you tend to take notice.
As easy as it may seem
to point the finger at the medical establishment, blame for the
increased risk of exposure lay as often at the feet of patients
as it does on the shoulders of their doctors. Over-prescription
is the most common cause of medication resistance in bacteria. Ironically,
because viral infections like the common cold and the winter flu
do not respond to antibiotic treatment, prescribing antibiotics as
a blanket cure “just to be safe” was once thought by
most family doctors to be harmless. The sobering fact is, prescribing
antibiotics for non-bacterial infections reduces the overall effectiveness
of those drugs in the general population. Realizing this, more doctors
limit the issue of antibiotics exclusively to cases of bacterial
infection. So, many patients cannot understand their doctor’s
sudden reluctance to prescribe antibiotics, especially where children
are concerned.
Sadly, due largely to
the nation’s broken healthcare system,
it is still more cost-effective for a doctor to prescribe a “harmless” antibiotic
to allay a patient’s concerns than it is to spend office time
educating them.
What is important for patients to know? First, antibiotics do not
treat viral infections. Second, bacteria evolve much quicker than
multi-cellular organisms (like us) due to their rapid growth and
short lifespans, meaning several generations of bacterial cells may
proliferate in mere days. Thus, the genetic mutations that occur
naturally over time in all organisms can select for survival only
those lucky few bacteria that coincidentally develop antibiotic resistance.
This means taking antibiotics improperly actually causes drug resistance.
Lastly, antibiotics work differently from patient to patient and
against certain bacterial strains. For one person with a throat infection,
an older antibiotic like amoxicillin may be enough, but for more
and more people newer, stronger drugs like zithromax are the only
effective remedies. However, these newest drugs are unreasonably
expensive.
There are things we all can
do to stop the assault of resistant bacteria. Since people are living
longer, healthier lives, sanitation procedures such as chlorination
and high temperatures at healthcare facilities and nursing homes
must be improved. The lack of education on the subject to patients
and caregivers and the complacence by doctors are correctable issues.
By working together, we can slow the spread of killer versions of
bacterial infections like staphylococcus and streptococcus into the
mainstream.
