- WASHINGTON (Reuters) - Virtually all strains of the common staph bacterium
are now resistant to penicillin, other bugs are rapidly developing drug-resistant
forms, and the costs are rocketing, yet no one is tracking these ``superbugs''
in an organized way, disease experts said Thursday.
- They said governments, doctors, drug
companies and academic researchers must join forces to find out where and
why drug-resistant microbes are emerging.
- ``This is a global public health problem,''
Dr. James Hughes, assistant surgeon general and director of the National
Center for Infectious Diseases at the Centers for Disease Control and Prevention
(CDC), told a seminar.
- Despite repeated warnings that soon some
infections would emerge that no drugs could treat, no one has taken concerted
action, he said, and the U.S. government is not helping. Hughes said the
CDC drew up a plan in 1994 for tracking emerging infectious diseases.
- ``We estimated in 1994 that the cost
for full, annual implementation of the plan would be $125 million,'' he
said. So far Congress has allotted $59 million, he said. President Clinton
has asked for $20 million for 1999, which would still bring the funding
to just $79 million.
- ``We've got a long way to go,'' he said.
The Institute of Medicine seminar was part of a series of forums on infectious
diseases. Experts discussed a report that found, for example, that 90 percent
of all strains of Staphylococcus aureus, the most common cause of infections,
some of them deadly, now resisted penicillin. Yet no one is keeping a careful
eye on how this is happening.
- ``No country, including the United States,
has a reliable, longitudinal, full-service antimicrobial resistance surveillance
program with comprehensive focus, nor is there a comprehensive database
for monitoring trends in antimicrobial usage,'' they wrote.
- ``Antibiotic-resistant bacteria generate
a minimum of $4 billion to $5 billion in costs to U.S. society and individuals
yearly, and in 1992 the 19,000 deaths directly caused by hospital-acquired
infections made them the 11th leading cause of death in the U.S. population,''
- One reason for their spread is the widespread
use of antibiotics. The more bacteria are exposed to the drugs, the easier
it is for them to evolve into resistant forms. Doctors are overusing antibiotics,
they said, in part because more children than ever are showing up with
infections, and their parents press hard for them to be given drugs. No
quick and easy test exists that will tell if an infection is caused by
a bacterium or a virus -- or, if it is bacterial, whether it is caused
by a drug-resistant strain. ``We need more information on factors that
influence physician prescription practices and patient demand,'' Hughes
- People fail to take simple precautions
like washing their hands, even in hospitals, or taking a full course of
antibiotics so no bacteria survive to become resistant. ``Every one of
us are to blame,'' said Dr. Gail Cassell, vice president for infectious
disease research at Eli Lilly & Co. Doctors and dentists are not trained
in how microbes grow to resist drugs, she added. ``There's a great need
for public education at large,'' she said.
- The need is urgent, Hughes said. ``We
are overdue for the next influenza epidemic,'' he told the seminar. Flu
is a virus and thus antibiotics are useless against it. But the bacterial
infections that often develop in people who have flu were once easily treated.
With the rise of drug-resistant forms, the next epidemic of flu could see
serious complications, Hughes said.