A Spot of Great News in the Bad

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Scary superbugs continue to dominate this week's news with a major article in The Wall Street Journal. But buried in the horrific rundown on community MRSA and deadly hospital pathogens is the best news I've seen in a long time.

Near the end of Theo Francis's "Putting Superbugs on the Defensive," he reports: "[The University of Pittsburgh Medical Center] requires physicians to get approval from an antibiotic-management team when using certain high-powered antimicrobials that could affect the body's natural defenses against the bacteria."

Clostridium difficile.gif


The bacteria that Francis references is a an extremely toxic, hospital-bred strain of Clostridium difficile, which moves in when antibiotics raze the intestinal tract's normally tight knit community of native bacteria. Ordinary strains of C. difficile are ubiquitous in our environment and have long been the primary cause of so-called antibiotic-associated diarrhea, which runs the gamut from annoying to life-threatening. As regular readers of this blog know, US hospitals bred a highly deadly strain of C. difficile sometime in the late 1980s. Since then it has killed thousands of hospital patients, many of them having checked in for routine procedures that involved a course of antibiotics.

Some infection control specialists dared to hope that toxic C. difficile would be the jolt that would wake physicians to the dangers associated with razing their patients’ “good” bacteria. C. difficile isn’t the only superbug that moves in when antibiotics open up the parking places in the intestinal tract. Case Western’s Curtis Donskey, for example, has shown that the longer hospital patients remain on antibiotics, especially powerful gut-razing antibiotics, the more likely they are to pick up and spread vancomycin-resistant enterococcus (VRE), one of the most drug resistant and dangerous of hospital superbugs.

Powerful antibiotics are life-saving drugs, to be sure. But like most forms of chemotherapy, they have potentially dangerous consequences. It’s heartening to see hospitals using them more wisely. The reward: Francis reports that the Pittsburgh Medical Center has slashed its C. difficile infection rates by two-thirds from an all-time high in 2000.

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