
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: TUESDAY, September 19, 1995                   TAG: 9509200001
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A-1   EDITION: METRO 
SOURCE: Associated Press
DATELINE: SAN FRANCISCO                                LENGTH: Medium

HOSPITALS TRYING TO HEAD OFF NEW UNKILLABLE SUPERGERMS

Hospitals across the country are beginning to restrict the use of their most potent antibiotics and isolate their sickest patients to try to stop the evolution of ``super bugs'' - germs that resist all known drugs.

Of special concern is the emergence of resistance to vancomycin, an antibiotic that is the sole remaining weapon against some of the most lethal microbes.

The spread of drug-resistant germs is the No.1 topic among the 12,000 infectious-disease experts at this week's Interscience Conference on Antimicrobial Agents and Chemotherapy, sponsored by the American Society for Microbiology.

``We really are running out of therapeutic options for common diseases,'' said Dr. Michael Scheld, the conference's program chairman.

For patients, the rise of drug-resistant germs means the medicine they get for their infection may not make them better. Often, this is little more than an inconvenience. More than 100 antibiotics are now on the market, and if one fails to work, doctors can always switch to another.

However, many fear the time is growing near when there will be no alternative antibiotic to turn to.

Since people are most likely to catch antibiotic-resistant germs in hospitals, many hospitals are developing strategies to control their spread.

Some, such as the University of Virginia Health Sciences Center, are experimenting with limiting doctors' ability to prescribe vancomycin, since indiscriminate use of the medicine is likely to speed up the evolution of resistant bugs. Physicians can get it only for a few accepted uses.

Dr. Anne M. Anglim said that before the restrictions, 61 percent of the vancomycin prescriptions were inappropriate. Afterward, 29 percent were.

Already, some strains of a relatively harmless form of bacteria called Enterococcus faecium are resistant to all antibiotics. Occasionally, these germs cause lethal bloodstream infections. However, they are usually a danger to only the sickest patients, whose immune systems are already weakened.

Far more dangerous is an extremely common hospital-spread bug called Staphylococcus aureus. This germ is the leading cause of wound infections after surgery and often causes pneumonia and bloodstream infections. This staph germ can be fatal unless killed with drugs. And often the only medicine that will control it is vancomycin, which has been on the market since the 1960s.

``The worst fear we have has not happened yet, but there is no guarantee it won't,'' said Dr. Clyde Thornsberry, director of MRL Pharmaceutical Services in Franklin, Tenn., which monitors antibiotic resistance worldwide.

by CNB