- For the first time, doctors have documented a large-scale
U.S. outbreak of antibiotic-resistant strep throat -- an episode involving
at least 46 Pittsburgh schoolchildren.
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- Until now, antibiotics have easily killed group A streptococcus,
the bacteria that cause strep throat and life-threatening septic infections,
so doctors at Children's Hospital of Pittsburgh were startled by its sudden,
widespread resistance to widely used erythromycin. The drug is commonly
given to people allergic to penicillin and other patients.
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- Doctors suspect the strep bacteria also are becoming
resistant to other popular drugs in the same antibiotic family, the macrolides.
Their use is growing because they require only one dose a day, compared
with three for many other antibiotics.
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- The jump in resistance began early last year at a Pittsburgh
private school, where roughly half the strep throat cases were found to
be untreatable with erythromycin. All the children were successfully treated
with other drugs.
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- "It definitely went from one kid to another in the
school and it also spilled over into the community," said lead researcher
Dr. Judith M. Martin of the hospital's Division of Allergy, Immunology
and Infectious Disease. "Where it started, I don't know."
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- The study was reported in Thursday's New England Journal
of Medicine.
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- Dr. Chris Van Beneden, an epidemiologist at the Centers
for Disease Control and Prevention, said the CDC will investigate.
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- "In may be occurring in other places across the
country," she added.
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- Dr. Lincoln P. Miller, head of the Newark infectious
disease outpatient clinic at University of Medicine and Dentistry of New
Jersey, said the findings show doctors should limit use of all macrolide
drugs.
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- "This is an important article because it indicates
the impact of our antibiotic use on the bacteria around us," Miller
said. "I would hazard a guess and say (this resistance is) fairly
widespread."
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- Doctors have long warned that overuse of antibiotics
is making some germs immune. Antibiotic resistance has been growing in
another type of streptococcus that causes pneumonia, but a recent survey
of half the states found that less than 3 percent of group A streptococcus
samples were resistant to erythromycin and closely related azithromycin.
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- In 1998, Martin began tracking group A streptococcus
at the private elementary school, taking thousands of twice-a-month throat
cultures from children. In January 2001, the doctors began seeing many
samples of the same group A strain resistant to erythromycin -- in all,
48 percent over that winter. Forty-six of the students had the antibiotic-resistant
form of strep throat.
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- In addition, a random check of samples from children
treated for throat infections at Children's Hospital found 38 percent had
the identical resistant strain.
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- In an editorial, Dr. Pentti Huovinen of Finland's National
Public Health Institute wrote that prevalence of group A streptococcus
that cannot be treated by macrolide drugs began increasing in 1990. When
regulations limited their use, the resistance problem dropped sharply.
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- Copyright © 2002, The Associated Press
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- http://www.newsday.com/news/nationworld/wire/sn
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