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Gram-negative bacteria are drug-resistant superbugs to watch out for

(http://www.cnn.com/2009/HEALTH/dailydose/02/20/gram.negative.bacteria/index.html)

Overview

A new crop of drug-resistant superbugs is in our midst, and experts believe that they could rival the deadly superbug MRSA.

A new report from the Infectious Diseases Society of America says these superbugs are creeping onto the radar in hospitals across the country, and our ability to fight them is next to none.
Questions and answers

Are these new superbugs poised to be the next MRSA?

Dr. Sanjay Gupta, CNN Chief Medical News Correspondent: They just may be, according to that new report by the Infectious Diseases Society of America, but we can't say that just yet. MRSA is still a much bigger problem.

First, let's define what these superbugs are. They're called "gram-negative" bacteria. They are extremely drug-resistant; they have long, complicated names like "acinetobacter baumanii" and "klebsiella pneumoniae." Two important issues related to these bacteria: They are increasingly cropping up in hospitals, and they are nearly impossible to treat. Dr. Gupta's Blog: Here's why you should be scared of superbugs

Is this related to the Brazilian model who recently died from a bacterial infection?

Gupta: Yes. A gram-negative bacterial infection killed Brazilian model Mariana Bridi da Costa last month. She had her hands and feet amputated and kidneys removed to try to stem the infection's spread before she died. Gram-negative bacteria are also responsible for a spate of infections among returning Iraq war vets.

We've talked a lot about MRSA โ€” methicillin-resistant Staphlyococcus aureus โ€” and the core issue there is that very few antibiotics can treat it. The biggest concern with gram-negative bacteria is, there are virtually no drugs to effectively treat them. One drug, Colistin, is the only option that sometimes works, but it is incredibly toxic โ€” can cause kidney damage.

So how do these infections spread?

Gupta: Gram-negative infections are spread almost exclusively in hospitals, whereas MRSA has escaped the hospital confines and can now be found in the community. But keep in mind that MRSA started in hospitals.

Doctors see gram-negative infections among patients who are already very ill. Might be babies in the NICU, very old patients, patients who've just had surgery, burn patients in the ICU, for example. Gram-negative bacteria can enter the body by way of catheters, IVs, ventilators or wounds.

How common are gram-negative infections?
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Gupta: The exact number of gram-negative-related infections or deaths is hard to pin down, because these infections are not reported routinely to the CDC. But doctors we spoke with say that the numbers could one day rival MRSA numbers, and that's really raising eyebrows among infectious-disease experts.

If there are virtually no drugs to treat gram-negative bacteria, then what are the options to stem the spread of these infections?

Gupta: Hospitals have to practice infection control: handwashing between patients; patient families also washing hands. Sometimes isolating patients in a different room if they are found to have an infection. Like with MRSA, not overprescribing antibiotics; that's how these bacteria learn how to adapt and become less treatable. And finally, more research into treatment.

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