The Tax Man Cometh

April 15th is the deadline for taxpayers in the United States to turn in their income tax return. Many people end up having to pay the tax man. As a result, we procrastinate. Another day will not matter. I can do it next week is the common refrain. However, eventually it all catches up to you and the bill must be paid.

That is how it has been in our dealings with the microbial world. In the 1930s and 1940s new drugs appeared in the marketplace that could kill bacteria and not harm humans. These drugs were called antibiotics. Antibiotics revolutionized our world. With these antibiotics the grim reaper of death's visits in the guise of a bacterial infection became less frequent.

Unfortunately, bacteria are not unchangeable little annoying creatures. They change right along with our world. When a new antibiotic was promised to be the cure for all bacterial diseases a bacterium would in some way prove us wrong. Instead of taking these warnings we just hoped for a new wonder drug that would help us all. With over 120 of these wonder drugs to choose from we got a little sloppy. If a person is sick just give them this little pill and they will get better. These antibiotics are in some cases still given out like sick people's candy. Unfortunately, many of our illnesses are not bacterial and most antibiotics we receive will not kill a virus.

This carefree attitude lead to many of the bacteria that dwell in and on us to become resistant to many of our antibiotics just to defend themselves. When you have a good thing you share it and many normal bacteria in and on us will share their new found abilities with others. Sometimes those others are bacteria that can cause serious infection.

One of those really nasty organisms is a bacteria called Staphylococcus aureus. A recent "Brief Report" in the New England Journal of Medicine (Feb. 18th, 1998, volume 340, number 7, pages 517-523) described a patient that died in a New York City hospital (United States) from an infection with a strain of Staphylococcus aureus that is resistant to vancomycin.

Vancomycin is what is called an antibiotic of last resort or a big gun. When all else seems to fail vancomycin was the antibiotic that could be used to help very ill patients. The organism in this patient was already resistant to many different antibiotics. The researchers further characterized this vancomycin resistant Staphylococcus aureus or VSA and found out that this strain of Staphylococcus aureus contained a small population of cells that were very resistant to vancomycin.

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