Saturday Mailbox

SATURDAY MAILBOX

October 27, 2007

Abusing antibiotics breeds bad bacteria

The steps the editorial "Being sensible about staph" (Oct. 19) outlines for controlling methicillin-resistant Staphylococcus aureusbacterial infections will probably be ineffective.

Staph bacteria are a constant inhabitant of normal skin and are everywhere in the environment around us - they can't be easily washed away.

The Sun's two recent articles on staph infections overlooked the underlying causes of bacteria becoming resistant to antibiotics ("Battling the bug," Oct. 18, and "Deadly staph infection spreads," Oct. 17).

An old medical professor of mine, Theodore E. Woodward, who was an infectious disease specialist, predicted 30 years ago that waves of resistant bacteria would develop as a direct result of the overprescription of antibiotics for viral illnesses and, more significantly, the wholesale use of antibiotics in animal feed.

The mass antibiotic treatment of cattle, turkeys, chickens, pigs, etc. (and people, for that matter) allows them to be raised in crowded conditions.

This treatment of animals on a very large scale represents important bulk sales for pharmaceutical companies. And even newly invented and very effective antibiotics are immediately applied to masses of animals.

But drug resistance is encouraged when antibiotic doses are low and are not directed at eliminating specific bacteria. This allows large numbers of bacteria to survive and mutate to adapt to the drug.

Antibiotics are one of the most powerful tools of modern medicine and should be treated as such. They need to be used only when they are needed - otherwise, they become useless.

New antibiotics should be protected from the indiscriminate use that causes them to become ineffective.

The emergence of MRSA is only a warning shot from the bacterial masses.

It will soon be followed by others.

Dr. Douglas Carroll

Lutherville

The writer is a retired emergency physician.

Hospitals striving to stop infections

The Sun's articles on the rapid spread of infections from antibiotic-resistant bacteria failed to note the innovative efforts by Maryland hospitals to eradicate this public health crisis ("Battling the bug," Oct. 18, and "Deadly staph infection spreads," Oct. 17).

The Maryland Patient Safety Center has been working for years with state hospitals to find effective ways to counteract this virulent strain of bacteria commonly found on the skin.

Anyone who even visits a health care facility can inadvertently spread MRSA. This can occur by way of our hands, clothes or equipment.

But Maryland hospitals have developed new rules to ensure frequent hand-washing or use of a sanitizer before hospital staff members come into contact with patients.

Hospitals are meticulously cleaning equipment and testing patients admitted to their intensive care wards for MRSA.

Ten Maryland hospitals have taken a drastically different approach called Positive Deviance, which aims to find ways that make it nearly automatic for everyone to follow infection-prevention practices.

Under this program, in one hospital, members of the clergy even started covering their Bibles with surgical caps to avoid spreading bacteria from patient to patient.

Simply placing hooks on walls outside isolation rooms has helped prompt doctors to hang their coats there and don protective gowns.

Stamping out invasive MRSA is difficult, but Maryland's hospitals are national leaders in this effort.

Our state's hospitals, as well as local health departments, schools, long-term care facilities and other health providers, will need to work in concert to battle this aggressive bug.

It is a top priority.

Dr. William F. Minogue

Elkridge

The writer is executive director of the Maryland Patient Safety Center.

Too soon to place Schaefer on pedestal

As a native Marylander and a Baltimore taxpayer, I want to protest in the strongest terms the proposed statue of former Mayor William Donald Schaefer at Harborplace ("Panel to decide on Schaefer statue at harbor," Oct. 23).

At an estimated cost of $300,000 to $400,000, the planned idolatrous image would be too much, too soon.

Let us not forget that whatever his merits or defects, Mr. Schaefer is, though elderly, still alive. The book of his life is far from closed and, with modern health care, he has time - and, to judge from recent events, inclination - to end it badly.

Yes, some people prefer to hark back to Mr. Schaefer's mayoralty, when he is credited with revitalizing the sagging economy and self-esteem of a Rust Belt city that has now allegedly blossomed into a born-again boomtown. And some fondly recall his catchphrase of "Do it now!"

But what about Mr. Schaefer's other contributions to public discourse?

His police-escorted house calls, as governor, to obscure citizen critics? His description of the Eastern Shore as an outhouse (to put the point more politely than he did)?

His outburst, as state comptroller, against immigrant workers at McDonald's whose English he found faulty? His headline-grabbing admiration of a young female aide's behind?

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