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University of Iowa News Release

April 1, 2005

Task Force Issues Report On Antibiotic Resistance In Iowa

The number of reported infections caused by a bacteria resistant to certain antibiotics increased steadily from 1999 to 2003, according to the task force monitoring antibiotic resistance in Iowa.

Surveillance data from the Iowa Antibiotic Resistance Task Force shows the number of reported infections from invasive methicillin-resistant Staphylococcus aureus (MRSA) rose from 102 in 1999 to 186 in 2003. The numbers are based on isolate submissions sent by hospital laboratories around the state to the University Hygienic Laboratory (UHL) for surveillance.

Staphylococcus aureus bacteria can cause a variety of illnesses, from pneumonia and sinusitis to bloodstream and urinary tract infections.

"What is happening in Iowa in terms of antibiotic resistance is similar to what is happening in other states," said Michael Pentella, Ph.D., a public health microbiologist at UHL and a member of the task force. "We're hearing a lot more about MRSA, not just hospital-acquired infections but increasingly more community-acquired infections."

The finding is included in the recently released second edition of "Iowa Antibiotic Resistance Task Force: A Public Health Guide." Established in 1998, the group -- made up of medical and public health professionals from around the state -- monitors and evaluates the prevalence of antibiotic resistance in Iowa and develops guidelines for combating the emergence of antibiotic-resistant bacteria.

The report is being sent to nearly 8,000 health care providers around the state, with clinical practice guidelines on the management of acute ear infections, posters for patient areas at doctors' offices and brochures for the public.

A strain of Staphylococcus aureus now exists that is resistant to all antibiotics except vancomycin. This poses a growing public health concern, noted Mary DeMartino, a public health microbiologist at UHL and a task force member. "If we lose this last drug of choice, we are talking about a bacteria that can cause serious illnesses with no antibiotics left to treat them," she said.

There have been four reported cases of vancomycin-resistant Staphylococcus aureus (VRSA) in the United States, each acquired in a hospital or nursing home setting. No VRSA infections have been confirmed in Iowa, although UHL has received suspect isolates from laboratories around the state.

"The statewide surveillance program normally only looks for certain organisms in invasive sites such as the blood or spinal fluid. However, because the potential for VRSA is so critical to public health, we included surveillance for this organism at any site," DeMartino said. "The fact that we've had two or three hospital laboratories submit suspected VRSA isolates indicates their vigilance. They're actively looking for this organism in order to prevent its spread."

The task force report contains new guidelines that promote "watchful waiting" when dealing with ear infections. Such illnesses are common in children but many are viral infections and, therefore, are not treatable with antibiotics.

The key message for health care providers and the public is to be aware of the difference between bacterial and viral infections and to use antibiotics judiciously, Pentella and DeMartino said.

"Physicians are encouraged to educate their patients on when an antibiotic is -- and isn't -- appropriate," DeMartino said. "Antibiotics won't help cold and flu viruses, but many people believe an antibiotic is what they need, so that's what they ask from their doctor. In the long run, taking unneeded antibiotics only contributes to bacteria developing antibiotic resistance."

Despite the emergence of antibiotic resistant bacteria, efforts to get the word out about antibiotics -- and prevent the spread of illness, in general -- are working, Pentella said. "People are better now at getting flu shots, for example, which reduces the instances when people may demand an antibiotic," he said. "Plus, not having the flu virus reduces the risk of getting a secondary bacterial infection, which can happen especially among debilitated patients or those more susceptible to disease."

Promoting the age-old message of "wash your hands" remains as important as ever, Pentella and DeMartino emphasized.

"Proper hand-washing is still one of the easiest and best ways to prevent the spread of any illness," DeMartino said. Antibacterial soaps are okay, but not necessary in terms of prevention, she added.

"Rubbing your hands together with plenty of soap and rinsing with water is the activity that will get rid of the germs. Any soap will do," Pentella said.

Pentella and DeMartino noted that tracking antibiotic resistance in Iowa remains a collaborative effort, involving medical, public health, nursing, clinical laboratory and veterinary medicine professionals. They added that with additional federal or state funds, screening for resistance could be expanded and more organisms could be tested.

The Iowa Antibiotic Resistance Task Force report is available online at http://www.idph.state.ia.us/adper/common/pdf/antibioticreport.pdf

It also is accessible through the Hygienic Laboratory Web site at www.uhl.uiowa.edu.

STORY SOURCE: University of Iowa Health Science Relations, 5139 Westlawn, Iowa City, Iowa 52242-1178

MEDIA CONTACTS: David Pedersen, (319) 335-8032, david-pedersen@uiowa.edu or Becky Soglin, 319-335-6660, becky-soglin@uiowa.edu