Resistant infections spur hunt for new strategies

Increasing incidence of MRSA is a symptom of this continuing public health crisis.

By Victoria Stagg Elliott, AMNews staff. Nov. 21, 2005.

For Russell Bird, MD, bacteria resistant to methicillin has become so firmly entrenched in his community that he considers it a fair bet that most of the skin infections he sees will fall into this category.

"Over the summer, we were seeing two cases [of methicillin-resistant Staphylococcus aureus] a day. Last year, we saw none," said Dr. Bird, a family physician working at Baptist Urgent Care in Louisville, Ky. "It's very scary. I've almost stopped culturing because of the antibiotic pressure in the community. It's all MRSA."

As a result, many antibiotics are off the table. He can still use the sulfa drugs. But, in an age of shrinking options to treat infectious disease, he's afraid that someday soon he'll lose those too.

Dr. Bird is by no means alone in this concern.

MRSA's jump from its traditional hospital-setting bunker to the general community where it has been causing death and serious illness among otherwise healthy people represents the dangers that can arise when the war against antibiotic resistance suffers a setback. It has since given physicians and scientists increasing motivation to look outside the box for new defenses. Last month, for instance, the National Research Council's two committees on New Directions in the Study of Antimicrobial Therapeutics issued a roadmap toward such solutions.

"We used to have great antibiotics. What are we going to do?" said Arturo Casadevall, MD, PhD, chair of one of the committees and professor of infectious diseases at Albert Einstein College of Medicine in New York. "We are in real danger."