Surviving the New Killer Bug
A nasty, drug-resistant staph infection--the kind usually seen in hospitals--is racing across the U.S.

Jewaun Smith, a 9-year-old boy from Chicago, is lucky to be alive. A scrape on his left knee that he picked up riding his bike last October turned into a runaway infection that spread in a matter of days through the rest of his body, leaving his lungs riddled with holes. Jewaun managed to survive, but what worries doctors most about his near-death experience is that it's not an isolated case. The bacteria that infected his knee has become resistant to the most common antibiotics and is on the march across the U.S. It has spread rapidly through parts of California, Texas, Illinois and Alaska and is beginning to show up in Pennsylvania and New York.

"This bug has gone from 0 to 60, not in five seconds but in about five years," says Elizabeth Bancroft, a medical epidemiologist at the Los Angeles County Department of Health Services. "It spreads by contact, so if it gets into any community that's fairly close-knit, that's all it needs to be passed."

This is not bird flu or SARS or even the "flesh-eating bacteria" of tabloid fame. But it is every bit as dangerous, even if it goes by an uncommonly ungainly name: community-acquired methicillin-resistant Staphylococcus aureus (MRSA).

Never heard of it? Neither have most doctors. But major new health threats don't usually announce themselves with press releases. A quarter of a century ago, the world learned about the AIDS epidemic because a health bureaucrat noticed an uptick in prescriptions for treatment of a rare pneumonia. In 1912--more than a half-century before the Surgeon General's report--a New York physician chronicled "a decided increase" in lung cancer, which was considered rare at the time, and suggested that cigarettes might be the cause.

Which helps explain why infectious-disease specialists in the U.S. are so alarmed by the new killer bug. "We're out here waving our arms, trying to get everyone's attention," says Dr. Robert Daum, director of the University of Chicago's pediatric infectious-disease program, who was one of the first to call attention to the rapid spread of MRSA, back in 1998. "People talk about bird flu, but this is here now."

Hospital workers know all about drug-resistant bacteria. Several strains have been making the rounds of the biggest hospitals for the past 15 years or so, often posing a greater risk for patients than the condition they were admitted for. But until the late 1990s, epidemiologists assumed that the problem was restricted to large hospitals and nursing homes.

The MRSA strains turning up in the community at large are related to but different from the ones found in medical institutions. The hospital variety usually requires intervention with powerful intravenous antibiotics and is pretty hard to catch. By contrast, the new strains of MRSA respond to a broader range of antibiotics but spread much more easily among otherwise healthy folks. The bugs can be picked up on playgrounds, in gyms and in meeting rooms, carried on anything from a shared towel to a poorly laundered necktie.

One of the difficulties in tracking MRSA is that doctors rarely check for it. The standard test usually takes a couple of days, and hardly any doctors do it anymore because everyone assumes that most skin infections respond to the usual antibiotics. "HMO's aren't going to be paying for you to do a culture on what they consider to be a [common] skin lesion," Bancroft says.

Source: Time.com

Pretty scary stuff, Geoff.

Superbug outbreak kills at least 49

NEW concerns about a virulent superbug emerged last night after three hospitals in Leicester admitted that it had killed at least 49 people and possibly as many as 78 this year.

The “hypervirulent” strain of the Clostridium Difficile (C Diff) superbug emerged at the Leicester Royal Infirmary, Leicester General hospital and Glenfield hospital, which is in the constituency of Patricia Hewitt, the health secretary.

The Healthcare Commission launched an inquiry earlier this year after an outbreak of the C Diff bug killed at least 20 people at Maidstone hospital in Kent. It was also responsible for the deaths of at least 33 patients at Stoke Mandeville hospital in Aylesbury, Buckinghamshire, between October 2003 and June last year.

Dr David Jenkins, director of prevention and control for University Hospitals of Leicester NHS Trust, said the bug was not new but that the latest strain was extremely virulent.

“NHS trusts are not required to keep information on those deaths where C Diff may have been a contributing factor,” he said. “However, we are analysing this as part of the battle against the new, hypervirulent strain.”

He claimed that infection in at least 20% of cases had occurred outside hospitals, but the main cause is dirty wards, overcrowding and a shortage of beds. Earlier this year the trust set up a taskforce of consultants, doctors, nurses and infection control specialists to fight the new infection.

Sylvia Greaves died in Leicester Royal Infirmary in May after being admitted for treatment on leg ulcers. Her children only learnt that she had died from the superbug after it was given as the cause of death on her death certificate.

Her son Barry Callow said: “We just want to know why this happened. Every time we ask a question the door slams shut.”

The Healthcare Commission announced an inquiry into an outbreak of C Diff at Maidstone hospital in Kent that killed six patients and was a factor in the deaths of 14 others between April and June this year. A total of 136 patients were infected with the bug in the space of three months.

The inquiry into Maidstone and Tunbridge Wells NHS Trust is one of only two that the commission has announced. It will examine outbreaks of the infection and evaluate how well the trust dealt with them.

The investigation was sought by the South East Coast Strategic Health Authority and the trust, whose three hospitals serve Maidstone and Tunbridge Wells and surrounding areas including Tonbridge and Sevenoaks.

Before the Maidstone outbreak 334 patients were infected with C Diff and at least 33 died between October 2003 and June 2005 at Stoke Mandeville hospital.

In July the Healthcare Commission published a highly critical report into the outbreak. It said that there had been serious and significant failings in the way in which senior hospital managers had responded to it.

The bacterium is found in the gut of about 3% of healthy adults and two-thirds of infants. It becomes a problem when other bacteria in the gut are disturbed, allowing C Diff to multiply and produce toxins that cause disease.

Sunday Times