Antibiotic resistance is increasing swiftly among the bacteria that cause meningitis, pneumonia, bloodstream infections, sinusitis and childhood ear infections, a new survey shows.

Researchers say that at the current rate of increase, more than 40 percent of all such infections will be resistant to at least two widely used antibiotics – penicillin and erythromycin – by the middle of next year. That’s up from about 9 percent in 1996.

In Atlanta, more than half of some types of Streptococcus pneumoniae, the microbe responsible for 6 million ear infections and 125,000 hospitalizations for pneumonia a year, are already too resistant to the two antibiotics traditionally used to treat such illnesses.

“Dually resistant strains are increasing much faster than strains resistant to either drug alone,” the researchers reported Sunday in the British journal Nature Medicine. They say that under current usage patterns of antimicrobial agents, strains resistant to both penicillin and erythromycin thrive more easily than singly resistant strains.

The latest findings come amid two other recent developments that chronicle the increasing problems of resistant bacteria:

• A 43-state survey of hospital intensive care units reported last month showed that the bacteria responsible for serious urinary tract infections and hospital-acquired pneumonia have grown increasingly resistant to Cipro, one of the newest and most widely used antibiotics. Researchers warned that in six years, the microbes’ overall susceptibility to Cipro dropped from 86 percent to 76 percent — a trend that could be halted only with “more judicious use of the drug and others like it.”

• In recent months, public health authorities in Los Angeles, San Francisco and Boston have reported outbreaks of a drug-resistant form of staph, which can be spread on contact. MRSA, short for methicillin- resistant Staphylococcus aureus, has caused deadly skin and bloodstream infections in hospitals and nursing homes for a decade, but has only recently emerged outside of institutions. Recent cases have also been reported in Europe.

In hospitals, some highly resistant “superbugs” have become resistant to all major classes of antibiotics – a development that, among some of the sickest patients, now makes once treatable infections sometimes fatal.

Sunday’s report is the latest sign that resistant microbes are also increasingly common outside of institutional settings, where doctors, patients and even the livestock industry, which uses tons of antibiotics a year, share the blame for the misuse of antibiotics.

“Most of the increases in resistance appears to be related to outpatient prescribing practices,” says Cynthia Whitney, an epidemiologist at the Centers for Disease Control and Prevention in Atlanta and one of the dozen authors of the study.

Whitney says a nationwide campaign by the CDC and medical associations to persuade doctors and patients to use antibiotics more judiciously is making progress. Many doctors now refuse to prescribe antibiotics for colds and other upper respiratory viral infections, which are unaffected by antibiotics.

Whitney says the rates of resistance, and prescribing practices reported by the CDC’s surveillance network, vary markedly by region. Although the precise reasons aren’t clear, the rates of penicillin-erythromycin resistance are five times higher in Georgia and Tennessee than in New York and California.

The report, based on statistics covering a population of 21 million people in eight states, shows that overall, the upward trend in resistance is continuing. The declining efficacy of the broad classes of antibiotics that include penicillin and erythromycin narrows doctors’ choices for the treatment of the numerous infections caused by Strep. pneumoniae.

Whitney says one bright spot is the growing use of the new PCV 7 conjugate vaccine, which is expected to prevent a major share of childhood ear infections – and reduce the need for antibiotics to treat them.

The vaccine has not been approved for adults, or children over the age of 5. But because ear infections in young children account for so many of the resistant strep infections each year, its use could help ease the need for antibiotics, which ultimately promote the emergence and spread of resistance.

With the need for 1.5 million doses of the vaccine a month, however, demand has outstripped supplies for the last two years. CDC officials predict that the shortage, once expected to be remedied by mid-2002, should end in the next quarter of this year.

Written by Mike Toner for Atlanta Journal-Constitution, and published on DrKelley.info, March 10, 2003. Embedded links (if any) may no longer be active. (Ed. 01.11.11)

FAIR USE NOTICE: This site contains copyrighted material the use of which has not always been specifically authorized by the copyright owner. We are making such material available in our efforts to advance understanding of environmental, political, human rights, economic, democracy, scientific, and social justice issues, etc. We believe this constitutes a ‘fair use’ of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U. S. C. Section 107, the material on this site is distributed without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes. For more information go to: http://www.law.cornell.edu/uscode/17/107.shtml