Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, March 13, 1995 TAG: 9503130098
SECTION: NATIONAL/INTERNATIONAL PAGE: A1 EDITION: METRO
SOURCE: NEWSDAY
DATELINE: NEW YORK LENGTH: Medium
Born three months premature, baby Elizabeth was a classic ``preemie'': tiny, underdeveloped and lacking any immune system that could protect her from infectious diseases.
For 10 months, Dr. Sharon Nachman and her team of pediatric specialists at New York's Stony Brook's University Medical Center battled a litany of infections that plagued little Liz, as her mother calls her.
``This baby had everything. You name it, she was infected,'' Nachman said.
``When Liz was 2 months old, I was told she was going to be a vegetable,'' said Morawski, a nursing student.
What ultimately saved Liz was an experimental French drug called Synercid, the last drug in a research pipeline that has dried up. No other unique antibiotics are anticipated until the 21st century, so experts are viewing Synercid as a treasure they dare not lose.
The Food and Drug Administration permitted the drug's use under its compassionate-use program, even though U.S. licensing of the drug is at least a year away. Liz was on the edge of death because she was infected with mutant strains of a common enterococci bacterium. For most people, enterococci are harmless. But for newborns or surgery patients whose immune systems are deficient, the organism can be extremely dangerous.
Until 1989, such infections were curable with an antibiotic called vancomycin. But the enterococci, aided by widespread inappropriate use of vancomycin, quickly developed resistance to the powerful drug. Bacteria use a variety of evolutionary tricks to try to outwit antibiotics, and if allowed to survive because drug use ceases prematurely, the organisms will develop genetic resistance.
After a succession of other infections and months on various antibiotics, 7-month-old Liz Morawski contracted resistant enterococci. Physician Nachman passed the baby's crib, noted her labored breathing and said, ``We're just sort of waiting now for the ax to fall.''
Fortunately, there was one more drug on the shelf, although it was experimental. And it worked.
But for how long, Nachman asks. ``As someone on the other end of the telescope, I see all the resistant bugs and I know what a problem it is.''
At Tufts University School of Medicine in Boston, Dr. Stuart Levy has made antibiotic resistance his life's work. For three decades, he has seen resistant mutants appear, warned health officials, then watched helplessly as his alarms were ignored and another drug was rendered useless.
As for Synercid, Levy said it's ``not possible that resistance won't occur. Thinking Synercid will save us is wrong. Wrong!''
Still, if used judiciously, Synercid might buy researchers time to develop other drugs, Levy said. The problem is that Synercid and its sister compounds, virginiamycin, streptogramin and pristinamycin, are already in widespread use in Europe, even in livestock, and resistance already has appeared.
``We have to tell doctors, `Don't always use bigger guns. Use the appropriate guns,''' Nachman said.
by CNB