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Two studies document rise of superbugs in the environment

ncreases and adjust treatment accordingly.

Prevention of MRSA infections mainly involves common sense. "If you get a cut or an abrasion, try to keep it clean and dry" and don't share towels or washcloths with others, Dr. Kaplan said. Most importantly, he added, "Wash hands, wash hands, wash hands."

And if regular drug-resistant bacteria weren't bad enough, some bacteria have become multidrug resistant (MDR). Researchers at the Beth Israel Deaconess Medical Center and Harvard Medical School studied the prevalence of bacteria resistant to three or more drugs over a six-year period. From 1998 to 2003, there was a significant increase in the incidence of patients carrying MDR bacteria when they were admitted to the hospital. Of the four species of MDR bacteria that the researchers examined, three of them--including Escherichia coli, a familiar bug that can cause urinary tract infections--were involved in the upswing.

The spread of multidrug resistance in bacteria appears to have two main causes, according to Aurora Pop-Vicas, MD, lead author of the Massachusetts study. The first is the intrinsic ability of bacteria to mutate and acquire resistance under antibiotic pressure. The second is the spread of MDR bacteria from patient to patient, often in hospitals or long-term care facilities like nursing homes. In the study, living in a long-term care facility, being 65 or older or taking antibiotics for two or more weeks were all factors that increased people's likelihood of carrying MDR bacteria upon admission to the hospital.

Physicians need to be aware of the risk factors for MDR bacterial infections, Dr. Pop-Vicas said, and should be judicious in prescribing antibiotics. Treating infections caused by MDR bacteria is "a therapeutic challenge," Dr. Pop-Vicas said, because for severe infections, physicians may need to administer medicine before the bacterial culprit--and its potential resistance to antibiotics--is known. In such cases, combin
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Source:Infectious Diseases Society of America


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