Don't give up just yet. Remember these really nasty staphylococcal strains are still very rarely encountered in most countries and they are only moderately resistant to vancomycin. If a bacterium is moderately resistant, raising the amount of antibiotic given to a patient can in many cases eliminate the infection. A recent article in The Scientist also gives hope that new antiobiotics are being discovered to treat these nasty organisms.
There was also a very exciting article in Science (Apr. 17, 1998) that reports a completely novel way of treating staphylococcal infections. These scientists have discovered a protein (RAP= RNAIII activating protein) produced by Staphylococcus aureus that turns on this organism's toxins. These toxins are what cause most of the damage in a patient. When mice were injected (vaccinated) with RAP they were able to make antibodies that bound to RAP. By binding to RAP the antibodies prevented RAP from turning on toxin production by Staphylococcus aureus.
Only 28 percent of mice that produced these antibodies to RAP developed skin abscesses when infected with Staphylococcus arueus. However, 70% of the control mice (ones that had not been injected with RAP) got skin abscesses after infection with live Staphylococcus aureus organisms. These studies demonstrated that shutting down the bacteria's ability to produce toxins will make it less virulent (able to cause disease). If the organism can't cause damage to the person then the immune system is better able to eliminate the organisms and no notable damage is done to the person.
Immunizing people with RAP is probably not feasible. However, if a small drug could be found that could interfere with the ability of RAP to bind to the staphylococcus, then another new way of preventing staphylococcal diseases could be utilized. I envision the addition of an antibiotic with a RAP inhibitor. The antibiotic would kill most of the organisms and the RAP inhibitor would stop any survivors from making toxins long enough for our immune system to kill them.
This novel treatment is many years from reality. However, if useful, we may be able to delay the multi-drug resistant bacterial nightmare for another generation.
Take Care and Think Microbiologically!
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