Fighting Superbugs
Are disease-resistant bacteria becoming unstoppable?
By Marcia Clemmitt

Antibiotics — the wonder drugs of the 20th century — are gradually losing their clout. Bacteria naturally develop resistance to antimicrobial drugs. In recent years, however, overuse of antibiotics has caused a growing number of staphylococcus bacteria to evolve into disease-causing “superbugs” resistant to drugs like methicillin. Hospital patients with MRSA — a potent. . . .

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Should tighter restrictions be placed on antibiotics in animals?

Rep. Louise M. Slaughter, D-N.Y. Chair, House Rules Committee. Written for CQ Researcher, August 2007	Richard Carnevale Vice President, Regulatory, Scientific and International Affairs, Animal Health Institute. Written for CQ Researcher, August 2007

How to Avoid Drug-Resistant Bugs

As antibiotics grow less effective, hygiene once again assumes a key role in protecting health.

Raised in an age before antibiotics, “Our grandparents told us, 'Wash your hands. Period. Wash before you eat. Wash after you go to the bathroom,'” says Stuart Levy, a professor of microbiology at Tufts University School of Medicine in Boston. Now, as the ability of antibiotics to treat infections wanes, those days are back, he says. “In developing countries, that means giving people clean water. For us, it means 'Wash.' ”

Here are some other tips for staying healthy:

• Be especially careful about hygiene in moist, sweaty environments, like gyms. Athletic locker rooms, including in major-league professional sports, have become breeding grounds for dangerous bugs like methicillin-resistant staphylococcus aureus (MRSA). “You shouldn't be sharing clothes or towels or personal items like razors,” says Jane D. Siegel, a pediatric infectious-disease specialist at the University of Texas' Southwestern Medical Center in Dallas.

• Avoid sharing personal objects like cell phones, too. Alla Lulu, a sophomore biology major at the University of Arizona (UA), picked up a nasty face rash after borrowing a friend's phone, said Charles Gerba, a professor of environmental microbiology at UA and Lulu's uncle. The phone carried staph bacteria.

• Avoid products like special soaps and detergents that contain antibacterials like the chemical triclosan. “There's no benefit to it over plain, old soap, and it drives resistance, so we need to be careful,” says Allison Aiello, assistant professor of epidemiology at the University of Michigan School of Public Health. These antibacterials, which are hard to avoid, leave residues that continue killing at a low rate, thus driving bacteria to become resistant. In a recent survey 76 percent of liquid soaps contained triclosan, and 30 percent of bar soaps contained triclocarban, according to the Alliance for the Prudent Use of Antibiotics. For tough cleanups, traditional antiseptics like alcohol, peroxide and bleach are the better choice. They kill quickly and leave no residue, so they're unlikely to increase resistance. Antibacterials like triclosan do have legitimate uses in health-care situations.

• Don't demand that your doctor give you an antibiotic, but if one is prescribed, take it for as long as directed. Otherwise, partly resistant bacteria still in your body can multiply and grow more resistant.

• Don't take anyone else's antibiotic. It may not be appropriate for your illness and will kill off beneficial bacteria in your body. “You've got hundreds of millions of bacteria in your intestines, and they ain't bothering you,” says John H. Powers, former lead medical officer for the Food and Drug Administration's Antimicrobial Drug Development and Resistance Initiatives. In fact, many carry out important jobs, such as synthesizing vitamins like Vitamin K, used in blood clotting, he says. “Bugs get a bad rap. They're only bad if they get in the wrong place.”

• If you're hospitalized, have someone there with you, especially on weekends and at night, says Lisa McGiffert, director of the Stop Hospital Infections project at Consumers Union. Hospital staff members might wash their hands and then touch the bed or a tray before touching you, but that shouldn't happen, says McGiffert. “You want them to go straight from the hand gel to you,” she says. Health-care workers “know that and they mean to do it right, so they won't mind being reminded.”

• When you have surgery scheduled, don't be afraid to ask the surgeon about the hospital's infection rate, says William Schaffner, chair of preventive medicine at the Vanderbilt University School of Medicine. Hospitals should also be able to tell you their hand-hygiene compliance rate, and you should ask, he says. “It is important to have a conversation with your surgeon,” says McGiffert. “Just ask, 'Can you tell me what you do to prevent infections?' You should get a number of answers,” including these: give antibiotics within 60 minutes of surgery; use the right antibiotic for the surgery; clip rather than shave the body pre-operation; keep the body warm during surgery and stop antibiotics within 24 hours of the surgery.

“You have to be your own advocate,” says Dee Dee Wallace, a 47-year-old Wisconsin mom who had a life-threatening brush with a resistant skin infection this year that doctors responded to slowly. “You have to say, 'I don't think this is right.' You know your own body. Stick up for yourself. Don't let them say, 'Go home, you'll be fine.' ”

[1] Quoted in Yusra Tekbali, Arizona Daily Wildcat, University of Arizona, “University Wire,” Aug. 1, 2007.

Footnote: 1. Quoted in Yusra Tekbali, Arizona Daily Wildcat, University of Arizona, “University Wire,” Aug. 1, 2007.

[2] “Antibacterial Agents,” APUA, http://www.tufts.edu/med/apua/Q&A/Q&A_antibacterials.html.

Footnote: 2. “Antibacterial Agents,” APUA, http://www.tufts.edu/med/apua/Q&A/Q&A_antibacterials.html.

[3] “When and How to Take Antibiotics,” Alliance for the Prudent Use of Antibiotics, www.tufts.edu/med/apua/Patients/How2Take.html.

Footnote: 3. “When and How to Take Antibiotics,” Alliance for the Prudent Use of Antibiotics, www.tufts.edu/med/apua/Patients/How2Take.html.

[4] Ibid.

Footnote: 4. Ibid.