The bug most drugs can’t cure

By Maryn McKenna

updated 7:12 p.m. ET Oct. 18, 2007

It started with something that looked like a spider bite.

Mollie Logan barely noticed it. She was focused on 15-day-old Isabella, the baby she and her husband had longed and tried for since their marriage four years earlier. The new mom was too happy, and far too sleep-deprived, to pay much attention to the small, hard red bump on her inner thigh.

The bump hurt, and it itched; Logan, then 24, absently scratched it. And it grew: In three days, the dime-sized pimple spread into a hot red band that encircled her leg. She headed to her primary care doctor, who drained the swelling and gave her an antibiotic mild enough to let her keep breast-feeding. Relieved the episode was over, she hurried home to Isabella.

That evening, while the baby was nursing, Logan felt an unfamiliar warmth. She rolled Isabella gently outward and froze: The baby’s right chest was as flushed and swollen as her mother’s thigh. Logan and her husband, Brian, rushed the feverish, limp infant to a pediatric emergency room in their section of Omaha, Nebraska, where doctors hooked Isabella to an IV of fluids to keep her hydrated.

It took 48 hours to find the right mix of drugs that could force down the baby’s 103.5-degree fever, while the Logans and their extended family fretted sleeplessly in hospital chairs. And it was another day before tests pinpointed the source of the problem. Isabella and her mother were both infected with an organism no one in their family had ever heard of, a bacterium known as community-associated methicillin-resistant Staphylococcus aureus—CA-MRSA for short.

The doctors explained that the bug was an aggressive staph infection with an ugly twist: Only a few drugs worked against it. Mother and baby needed much stronger antibiotics. Logan would have to stop breast-feeding, because her milk could pass even more drugs to Isabella, throwing off the baby’s treatment. Worse, 3-week-old Isabella required immediate surgery to clean out the angry abscess that was spreading across her chest. Two years later, Logan still weeps when she talks about it. “They told me, ‘We have only one chance to get this right,’” she says. “It was the toughest thing ever, to hand her over.”

Just the beginning
Isabella sailed through the surgery; the swelling quickly subsided, and her color and energy improved. After 10 days in the hospital, Logan brought her home. She had lost much of the first month of her daughter’s life but assumed the crisis was over.

She had no idea that this was only the beginning of her odyssey to the limits of medicine.

Bacteria and the drugs we deploy to kill them have been locked in an arms race since penicillin, the first mass-produced antibiotic, was first given to a patient in 1941. The first penicillin-resistant organism was found only one year later. Now a broad array of scientists and health authorities worry that the bacteria are gaining an edge in the race: Germs with built-in protection against antibiotics, such as the one that attacked the Logans, become more common every year.

“Every known bacteria capable of infecting humans has developed resistance to some antimicrobials,” says Robert C. Moellering Jr., M.D., professor of medicine and medical research at Harvard Medical School in Boston who has studied the issue of antibiotic resistance for more than 35 years. The overuse of antibiotics exacerbates the problem, Dr. Moellering says, because the more we expose germs to the drugs, the better they become at building resistance. Researchers suspect that the use of antibiotics in animal feed plays a role; drug-resistant bacteria may develop in animals such as cows, chicken and salmon and then infect humans who eat them.

For the past few decades, the perpetual struggle between bugs and drugs took place mostly in hospitals, among the most medically fragile patients. Almost 2 million people contract infections in U.S. hospitals every year, and about 90,000 of them die, according to the Centers for Disease Control and Prevention in Atlanta. Now the problem has begun to appear outside hospital walls, with resistant organisms causing a wide variety of infections in otherwise healthy people.

In 2001, for example, one in four children in day care centers studied in Michigan had a resistant form of a bacterium that causes ear infections, a scourge of toddlers. The same year, a study in The New England Journal of Medicine found that 22 percent of women treated for urinary tract infections at two college health centers in California and Minnesota had a drug-resistant form of E. coli. And in March of last year, the CDC reported finding a strain of the almost-vanished disease tuberculosis that is immune to at least five drugs, making it virtually impossible to treat except with the 19th-century method of cutting out pieces of lung.

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