Two reports show "superbug" bacteria spread

WASHINGTON Wed Oct 17, 2007 8:32am EDT

In this file photo a medical technical assistant holds a dish of bacteria culture at the Robert Koch scientific Institute in Berlin October 31, 2001. REUTERS/Alexandra Winkler

In this file photo a medical technical assistant holds a dish of bacteria culture at the Robert Koch scientific Institute in Berlin October 31, 2001.

Credit: Reuters/Alexandra Winkler

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WASHINGTON (Reuters) - Two drug-resistant "superbugs" are becoming more common across the United States including one that causes hard-to-treat ear infections in children, researchers reported on Tuesday.

Another, called methicillin-resistant staph aureus or MRSA, killed an estimated 19,000 Americans in 2005 and made 94,000 seriously ill, according to one report in the Journal of the American Medical Association.

Dr. Michael Pichichero and Dr. Janet Casey, both of the University of Rochester and Legacy Pediatrics, their practice in New York, found a new type of drug-resistant cases of Streptococcus pneumoniae in children with ear infections.

Five of those children had to be treated with an antibiotic approved only for adults because children's drugs were not strong enough to kill it.

The pediatricians said doctors could help prevent the ear infection problem by performing an old-fashioned, low-tech procedure called an ear tap, which can be used to both diagnose and sometimes treat the infections.

And both reports suggest that doctors and hospitals are not following guidelines for controlling bacterial infections.

Pichichero and Casey treated middle ear infections in 1,816 children and performed ear taps on 212 of them. This involves punching a hole in the eardrum to remove fluid and then testing the fluid to identify exactly what type of bacteria had caused the infections.

Doctors usually make a best guess and treat children's ear infections with whatever antibiotic they believe to be most appropriate, but Pichichero said this may not be optimal.

His team found nine children infected with a new strain of S. pneumoniae. Four had been through more than one round of antibiotics and five had to be treated with levofloxacin -- an antibiotic approved only for adults. The others were treated with an ear tap using novocaine.

"The child feels absolutely no pain," Pichichero said in a telephone interview.

DRAINING AN ABSCESS

"An ear infection is actually a kind of abscess behind the ear drum. Draining it immediately relieves the pressure and pain. It immediately brings the fever down. Fifty percent of the time there is no need for antibiotics at all."

The ear taps would allow doctors to identify precisely which strain of bacteria is infecting a child and choose the most appropriate antibiotic, Pichichero and Casey said.

And using antibiotics less often would help overcome the threat of antibiotic resistance and make the drugs more useful when they really are needed.

For the second study, Dr. Monina Klevens and colleagues at the Centers for Disease Control and Prevention sampled reports of MRSA from all over the United States.

"Based on 8,987 observed cases of MRSA and 1,598 in-hospital deaths among patients with MRSA, we estimate that 94,360 invasive MRSA infections occurred in the United States in 2005; these infections were associated with death in 18,650 cases," they wrote in their report.

MRSA infections can range from boils to more severe infections of the bloodstream, lungs and surgical sites. The researchers said 85 percent of all cases were associated with hospitals, nursing homes or other health care facilities.

MRSA is mostly spread on the hands, but also on contaminated medical equipment.

Experts have been warning for years that poor hospital practices spread dangerous bacteria, and yet study after study shows that health care workers, including doctors and nurses, often fail to even wash their hands as directed.

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