Of Microbes and Men - And MRSA : How the Administration's Public Health Policy Fosters Drug Resistant Microbes

Recent events have, once again, catapulted microbes into the forefront of media crisis-reporting. No sooner than the wandering TB-carrier evading the CDC's dragnet fades from our newspapers, (along with the sudden emergence and disappearance of SARS, the threat from Saddam's smallpox, and the billion dollar initiative against H5N1 - Avian flu - advertised as the greatest plague since the pandemic of 1918) - does a new scourge arise. This article posits that the sudden emergence of Methicillin Resistant Staphylococcus aureus (MRSA) as a a political, press, and conference issue diverts attention from fundamental, but less dramatic health and health care problems of our nation. Antibiotic-resistant microbes are not new . Nor is the rapid time for developing resistance. Hand washing, the venerable procedure promised to reduce the incidence, frequency and number of organisms capable of surviving our most potent antibacterials - isn't a novel solution either. It hasn't done away with the problem in the past, and we shouldn't rely on it now. Other putative solutions proffered by pundits and politicians will only aggravate the problem, or at best be inconsequential. Producing new antibiotics to cure the resistant bugs, as some suggest, will only compound the problem, while reporting new cases will provide more, but essentially useless information, but will clog the information cascade, obscuring more important data. This paper reviews some relevant history and biology, details the fallacies of currently promoted methods of addressing drug resistance, and discusses secular trends and government policy which exacerbate the problem. In addition, a seminal event that triggered the recent spate of MRSA-associated mortality is proposed and examined so repetition of events under human control can be avoided. A follow up article will suggest methods for curtailing community and hospital transmission based on fundamental principles of industrial hygiene