New strain of superbug invades Canada's Sick Kids' Hospital
Pastor Dale Morgan
New strain of superbug invades Canada's Sick Kids' Hospital*
The new strain 19A has caused a serious infection in a child at the
Hospital for Sick Children in Toronto, CTV News has learned.
Dr. Michael Pichichero is worried that this multi-drug-resistant
superbug could soon cause infections that invade the lungs and bloodstream.
CTV.ca News Staff
Updated: Wed. Nov. 7 2007 9:09 PM ET
Doctors in Ontario have identified a new antibiotic-resistant strain of
bacteria that's led to a case of meningitis in a child.
The bacteria, a new substrain of Streptococcus pneumoniae 19A, has
caused dozens of ear infections in Massachusetts and New York State.
Now, CTV News has learned that this new strain 19A has caused a serious
infection in a child at the Hospital for Sick Children in Toronto.
The child's illness developed into bacterial meningitis, a potentially
fatal infection of the fluid around the spinal cord and brain. The child
had been otherwise healthy and had received all the vaccinations
recommended for children.
Doctors may soon be asked by the Ministry of Health to watch for
recurrent ear infections that don't respond to treatment with
antibiotics, because they could be the result of this new strain.
Streptococcus pneumonia is not new in Canada. It causes hundreds of
chest and throat infections, ear infections. In rare cases, it triggers
pneumonia and meningitis, the illnesses that are usually easily treated
with antibiotics.
But doctors have identified the growth of a subtype of 19A that can't be
killed off with any of the antibiotics approved for use in children.
The patient at SickKids Hospital was treated with one antibiotic after
another without success. The infection only responded to powerful
antibiotics usually reserved for adults.
A team led by Dr. Michael Pichichero, a professor of microbiology,
immunology and pediatrics at the University of Rochester Medical Center
was the first to identify the new 19A super-strain while he was treating
children whose ear infections wouldn't clear up.
In October, he published a report in the Journal of the American Medical
Association, describing his experience with the 19A superbug. The
highlights of that report:
* He tried 18 antibiotics approved in the U.S. for children.
* In the end, the only drug that worked was levofloxacin, (also
called Levaquin), which is approved for adults and is not recommended
for children.
* For one child, the cure came too late, because the infection led
to permanent hearing loss.
Pichichero's team believes the new substrain was most likely created by
a combination by the superbug's ability to evolve quickly and the
over-prescribing of antibiotics which has led to antibiotic resistance.
Pichichero told CTV News that he's worried that this
multi-drug-resistant superbug could soon cause infections that invade
the lungs and bloodstream, where it could cause pneumonia or blood
infections.
"If this germ starts to cause infections in the brain or in the lungs it
could have devastating consequences," he says. "And if doctors aren't
aware that it could be the 19A superbug, they would not normally use the
one antibiotic that might work because that one antibiotic is not
actually approved for use in children."
What's more, the strain could also cause illnesses in adults, he says.
"We've learned over the years that young children spread their germs,
not only to each other in daycares and in schools, but also to their
parents and to their grandparents. So that the fact that we found this
superbug in children also has significant implications for the
possibility that it would also occur in adults," he says.
There is a childhood vaccine currently in wide use for Streptococcus
pneumoniae, a vaccine called Prevnar. Since its introduction in 2000,
the incidence of pneumonia and meningitis caused by this bacteria has
fallen by at least 69 per cent. As well, difficult-to-treat ear
infections were reduced by 24 per cent.
But Prevnar does not include this new 19A strain and so that vaccine
offers no protection against it.
The makers of Prevnar are reportedly aware of the new strain and are
reformulating their vaccine to include it. Other vaccine makers are
working on other formulations that are still being tested. But it will
take two years for a new vaccine to be approved and placed on the market.
In the meantime, doctors need to know that this strain is circulating,
and that if someone has a pneumococcal infection that isn't resolving --
like an ear infection that defies treatment -- it may need more
aggressive treatment.
The Centers for Disease Control in the United States has now begun to
track this 19A superbug. But as of yet, no surveillance for this strain
exists in Canada.
With a report by CTV medical specialist Avis Favaro and Elizabeth St. Philip