Spread of drug-resistant germ alarms officials

Four die, over 200 take ill from staph type previously limited to health care sites


WASHINGTON -- More than 200 people in Minnesota and North Dakota have become sick -- and four children have died -- over the past two years after becoming infected with a drug-resistant germ that until recently has been confined to hospitals and nursing homes, federal health officials said yesterday.

The fatalities are the first to be reported in the United States, and are worrisome because they suggest that a lethal strain of staphylococcus aureus may threaten the public. It is not known whether the germ has spread to other parts of the country, although some cases were reported last year among youngsters in Chicago and Tennessee.

"These serve as a warning sign, sort of like the canary in the coal mine, that there may be problems that lie ahead," said Dr. Tim Naimi, the medical epidemiologist who investigated the outbreak for the Centers for Disease Control and Prevention, a federal agency whose headquarters are in Atlanta. "It's sort of like an old fox has gotten into a new and much larger henhouse."

The germs exist in the nostrils and skin and can be passed through hand-to-hand contact, but are typically harmless unless they enter the body through a cut or a scrape, which enables them to travel through the bloodstream and attack a variety of organs.

There are drugs that kill the bacteria. But unless doctors have tested for it, patients may not get treated in time. And because it is difficult to tell when a patient is infected, the disease control agency is urging health care providers to obtain cultures from people who may have illnesses caused by bacteria.

Naimi said parents should not be alarmed but should take common-sense precautions, like cleaning cuts, washing hands frequently and seeking medical care if their children appear sick.

But other experts said the deaths, which are being reported in today's issue of the agency's Morbidity and Mortality Report, were a frightening development.

"That's scary," said Dr. Stuart B. Levy, director of the Center for Adaptation Genetics and Drug Resistance at Tufts University. Levy said it was particularly unsettling that robust youngsters lost their lives, as opposed to newborns, the elderly or people with immune disorders, who are more vulnerable.

"If we have kids dying of staph aureus infection in our communities," he said, "it tells us there is something wrong."

The identities of the dead children were not made public, and the disease control agency provided only sketchy details of their cases. The children ranged in age from 1 to 13 and had a variety of symptoms, including extremely high fever, rash, dangerously low blood pressure and difficulty in breathing.

All were treated in the hospital with very powerful antibiotics that should have worked against the germs. But they did not because the children's doctors had not expected to see infection with a drug-resistant germ, and thus did not realize quickly enough that the children needed such strong medication.

"The physicians were essentially blindsided," Naimi said, "because this problem is so new."

The victims included a 7-year-old African-American girl from urban Minnesota, who died in July 1997 after doctors diagnosed an infection in her right hip joint that eventually spread through her bloodstream to her lungs; a 16-month-old American Indian girl from rural North Dakota who died in January 1998, two hours after being admitted to a hospital with a fever of 105 degrees, dangerously low blood pressure and a rash; a 13-year-old white girl from rural Minnesota who died last January, seven days after she arrived at a hospital coughing up blood, with pneumonia eating away at her lung tissue; and a 1-year-old white boy from rural North Dakota who died last February after suffering a lung infection that rapidly developed into pneumonia.

That the cases were scattered across the two states and the children are racially diverse suggests that the germ is widespread across the region, Naimi said.

Baltimore Sun Articles
Please note the green-lined linked article text has been applied commercially without any involvement from our newsroom editors, reporters or any other editorial staff.