No Defense Restricted

It's scary to think that a reliance on disease-fighting drugs could be a "prescription for peril." A new report says that drug-resistant cases of tuberculosis are up 50% in Denmark and Germany over the past three years. It turns out some of the drugs that were medical breakthroughs are backfiring on us. CBS correspondent Rita Braver has the story.

Last summer Lisa Bousel's life changed. The third-grade teacher went into a Philadelphia hospital for sinus surgery, but she became a statistic: One of 70,000 people who each year are infected by Methicillin-Resistant Staphylococcus Aureus, commonly called MRSA.

"The next thing I know there's a whole language that's thrown at me that I don't know those words," says Bousel. "I think I was in so much shock. It was awful and it was scary, it was very scary."

MRSA is a staph infection that cannot be cured. The way it is supposed to be with the antibiotic Methicillin. Doctors put Lisa Bousel on vancomycin, a drug considered to be the big gun of antibiotics.

"But at this point it looks like vancomycin didn't really clear up the infection either," says Bousel. "No, it didn't. I was still testing positive after 4 weeks."

Lisa has just one of the many types of antibiotic resistant infections that are now worrying doctors--infections that cause tens of thousands of deaths each year.

"It's very much a race against the clock," says Dr. William Schaffner of Vanderbilt University Hospital in Nashville. "Because those of us in the infectious disease and public health are now at the point of being genuinely concerned about the spread of resistant infection."

Antibiotics were supposed to be a wonder drug in the fight against bacterial infection. Penicillin was the first major advance, saving thousands of World War II soldiers with infected war wounds. And over the years, drug makers came up with one antibiotic after the other to treat everything from ear infections to pneumonia, meningitis and a host of other illnesses.

Back in the 1960's, the U.S. Surgeon General actually predicted that we would soon close the book on infectious disease that could be treated with antibiotics. But neither he nor anyone else in medicine could predict the survival skills of the bacteria that cause those infections.

"These bacteria were recovered from a patient," says Schaffner. "That's a good antibiotic. That antibiotic works. But all of these other antibiotics which in earlier years used to work against the self-same bacteria don't work anymore. In other words, these bacteria are resistant to all of these antibiotics. This does not make an antibiotic physician happy."

In fact there are a lot of unhappy doctors at the annual meeting of the Infectious Diseases Society in Philadelphia. Dr. Schaffner shares his concerns with other specialists including Dr. Glenn Morris at the University of Maryland School of Medicine in Baltimore. They both believe there is one major reason so many antibiotics are becoming bsolete: Overuse.

"We are using so much antibiotics," says Morris, "so many in the community, in agriculture and in the hospital that we are strongly promoting the emergence of strains of bacteria that are resistant to our best drugs."

The Centers for Disease Control estimates that a whopping 50 to 60 million unnecessary prescriptions for antibiotics are written each year. The problem is that antibiotics work only against infections caused by bacteria. Antibiotics cannot cure the common cold or even the flu, both of which are caused by viruses. But that doesn't keep patients from demanding them.

"One of our problems is that we are finding that the heavy use of antibiotics in the community and in hospitals is resulting in the emergence of these resistant organisms," says Morris. "So, we are our own worst enemy in this."

Antibiotic resistant infections can be spread from one person to another. Hospitals are well known breeding grounds, especially if medical personnel fail twash their hands. But no one can be sure exactly how each infection is transmitted.

After Tabitha Gerrard had gall bladder surgery, she developed a resistant infection. She was sent to Vanderbilt University Hospital for treatment. After 3 weeks, doctors finally found a combination of drugs that cured her. She was one of the lucky ones.

Dr. Schaffner says it would have been more serious if Gerrard had not been treated, and it could have even been fatal.

There's another reason why many doctors believe that antibiotic resistant bacteria are appearing more often--widespread use of antibiotics in agriculture.

"We think the data are clear that use of antibiotics in animal husbandry leads to resistance in bacteria and those resistant bacteria will find their way into humans," says Schaffner.

No matter what the reason, the reality is that more and more people, often without even knowing it, are walking around with dangerous bacteria which though dormant for now, could prove harmful in the future.

"We are seeing an increasing number of bacteria which show antibiotic resistance that are just being carried by normal healthy people," says Dr. Morris at the University of Maryland.

"They are walking around, they are fine. That resistant organism in their intestinal tract is not gonna cause them any trouble whatsoever unless they happen to need a bone marrow transplant ten years from now for breast cancer and then suddenly we knock out their immune system. And then, that highly resistant enterococci can get into their blood and may turn out to be a fatal infection," says Morris.

So researchers like Dr. Morris are scrambling to develop still more antibiotics and other different treatments to block bacterial infections.

"For example we've been looking at bacteriophage, which are viruses that kill bacteria. There are a lot of different therapies that were used back before antibiotics that suddenly we're beginning to look at," says Morris.

The good new is that at this point, doctors say they are not greatly worried about a major bacterial infection spreading quickly through the population. But doctors warn of the possibility that things may go back to an earlier age when infectious disease was of concern.

"It's not so much that the andromeda strain which is going to wipe out the country. It's more that we are turning the clock back to an earlier age when infectious disease were of concern," says Morris. "When surgeries were limited by the problems of post operative infection where you did give somebody cancer chemotherapy which completely knocked out their immune system because if they got infected you couldn't do anything about it."

Lisa Bousel, the third-grade teacher from Philadelphia has found some relief from her pain in the ancient art of acupuncture, but her anxiety is undiminished. "I don't know what's going to happen to me," says Bousel.

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