Attack of The Superbugs

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The advent of penicillin drugs in the early 1940s ushered in a triumphant era of medicine. With stunning speed, pharmaceutical chemists armed doctors with one antibiotic after another, giving them an arsenal of magic bullets to knock out the germs that cause everything from pneumonia to gonorrhea. It was only a matter of time, it seemed, before all infectious diseases would be conquered.

But now the invisible legions of malevolent microbes are fighting back, and medicine is no longer so confident of winning the battle. Not only have many diseases caused by viruses, such as AIDS, proved to be extraordinarily difficult to cure, but even old, easily treated bacterial ailments do not always respond to drugs as they once did. Using marvelous powers of mutation, some strains of bacteria are transforming themselves into new breeds of superbugs that are invulnerable to some or all antibiotics.

The most publicized superbugs are the strains of drug-resistant tuberculosis bacteria that have caused outbreaks of the disease in U.S. hospitals and prisons over the past few years. And in a sobering series of articles in the current Science magazine, researchers point out that the problem of drug resistance is not limited to a few germs but spans an entire spectrum of disease-causing microbes, including those responsible for gonorrhea, meningitis, streptococcal pneumonia and staphylococcus infections. "Bacteria are cleverer than men," says Dr. Harold Neu of Columbia University's medical school.

In the U.S., superbugs have not yet caused large epidemics. The total number of tuberculosis cases reported last year was 26,283, up from a low of 22,000 in 1984, but still well below the 84,000 recorded in 1953. However, scientists are worried about the future. "We forgot that microbes are restless and that they would counterattack," says Richard Krause, a senior scientific adviser to the National Institutes of Health. "That was incredible hubris on our part."

In the world's poorer countries, the fight against infectious disease is already a disaster. Malaria, tuberculosis, cholera and dysentery may claim more than 10 million lives each year. While inadequate medical care and sanitation are mainly responsible for the death toll, increasing microbial resistance to drugs is making a bad situation worse. The antimalarial drug chloroquine is no longer broadly effective, and even the newest substitute, mefloquine, is encountering resistance from some strains of the malarial parasite.

Antibiotic-proof bacteria are spreading around the globe because of the enormous increase in tourism and business travel in recent decades. Last month a woman came to a New York City emergency room with a strain of cholera picked up in Ecuador that was impervious to a variety of antibiotics. Penicillin- resistant strains of gonorrhea, originally noted in Africa around 1976, have cropped up in the Philippines, Thailand and the Washington Heights section of New York City. Public health officials are particularly concerned about potentially fatal forms of dysentery in Central and South America that are resistant to half a dozen drugs.