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Some intensive-care units in New York and South Carolina are about to get copper fittings as part of a project to test if drug-resistant bacteria survive better on hospitals' ubiquitous stainless steel than on copper.
About 1.7 million Americans a year develop infections while hospitalized and almost 100,000 of them die, according to the Centers for Disease Control and Prevention. Scientists have long preached better hygiene to control hospital spread of germs, but increasingly medical manufacturers are looking to anti-germ coatings to help.
In November, the Food and Drug Administration approved sale of the first breathing tube coated with silver, a metal long known to somewhat repel bacteria.
Ventilator patients are at high risk of getting pneumonia. In a multi-hospital study, 7.5 percent of patients given a regular breathing tube developed pneumonia, compared to 4.8 percent of those given C.R. Bard Inc.'s new Argento ventilation tube, the FDA found.
Also this fall, Baxter HealthCare Corp. announced FDA clearance of a silver-coated IV catheter connector, designed to help prevent bacteria from clustering at this entry point to the bloodstream.
But a coppery hue in hospitals?
In a British study published last year, drug-resistant staph germs survived for three days on stainless steel plates kept at room temperature, but the researchers found no sign of the germs on pure copper after 90 minutes.
The new study, funded by a government grant to the Copper Development Association, is putting that finding to a real-world test involving three drug-resistant bugs - staph, enterococci and acinetobacter.
First, researchers are swabbing down a handful of ICU rooms at New York's Memorial Sloan-Kettering Cancer Center, the Medical University of South Carolina and Charleston's Veterans Affairs Medical Center. They must learn where the germs lurk, explains Sloan-Kettering lead researcher Dr. Kent Sepkowitz.
Then the hospitals will substitute copper for some germ-prone surfaces in those rooms, and track if the change makes a difference.
Copper is expensive, but so are hospital-caused infections, Sepkowitz says.
"The question is will it save more money than it costs," he says.
© 2007 The Associated Press.
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The idea: Don't just try to kill bacteria. The bugs will always find a way to thwart the next antibiotic.
The new goal is to disable bacteria's ability to sicken, so scientists can throw superbugs a one-two punch. And attempts to bust up germ gangs are leading the race to create these novel anti-infectives - using everything from compounds in Pinot Noir to some popular bone-building drugs.
"It's a stealth approach," says chemist Kim Janda of the Scripps Research Institute, who is developing a vaccine against notorious drug-resistant staph that prevents the bacteria from ganging up.
"We're trying to find the Achilles heel in drug-resistant bacteria," adds Matthew Redinbo of the University of North Carolina, Chapel Hill - who did find one.
Redinbo's team discovered that certain osteoporosis drugs blocked one E. coli germ from spreading antibiotic-resistance genes to another. Interrupting this recruitment of new gangsters confused the drug-resistant bugs enough that they committed suicide, leaving only easy-to-treat germs behind.
All of this research is in very early stages. But Dr. Julie Gerberding, chief of the Centers for Disease Control and Prevention, calls disarming bacteria a long-needed new approach.
It is "like lasers going in to destroy certain parts of the bacteria as opposed to a bomb that blows the whole thing up," Gerberding told Congress recently. These "next-generation strategies are not proven yet, but really something that needs a lot more attention and focus."
Indeed, despite a rise in bacteria that withstand today's best treatments, there are few novel antibiotics under development - and germs have evolved such complex ways to survive antibiotics' frontal assault that new ones eventually will wear out, too.
Hence the quest to disarm germs. Scientists are trying to disable "virulence factors," molecules that help germs worm their way into the body, or block germ-emitted toxins.
But much of the new research centers on simply keeping germs from clustering.
"We're finding new ways to prevent disease without killing the microbial agent ... rather, neutralizing it somehow," says University of Rochester dentist Hyun Koo, who is using compounds left over from vineyards' wine-making to bust up gooey bacteria masses known as biofilms.
Adds Scripps' Janda: "If you break them up, they don't have that strength in number. They're not going to do like a gang and beat people up."
Among the methods under study:
-Germs talk to each other, by sending out radar-like chemical signals that sense when enough of their mates are lurking for them to switch on and sicken. Scientists call this "quorum sensing." Jam their frequencies, and the germs won't know when they've got a quorum - they'll just hang around harmlessly until the immune system picks them off.
Janda's team designed a molecule that triggers the immune system to form bloodhound-like antibodies that gobble up the communication chemicals sent by deadly staph aureus bacteria. Janda injected some mice with those antibodies and others with a dummy drug. Then he gave all the mice a lethal dose of staph. The antibody-protected mice never got sick, while their unprotected neighbors died within a day.
-Other times germs need only to rub shoulders with a neighbor to start doing damage. Antibiotic-resistant E. coli snuggles up to a still treatable germ and shoots the newcomer with DNA that will turn it drug-resistant, too.
At UNC, Redinbo's team found the enzyme that sparks that whole process could be blocked by bone-building osteoporosis drugs already on the market, including one called etidronate. When they added just a bone drug, not antibiotics, to the drinking water of E. coli-infected mice, the rodents' bacteria levels plummeted. Why? The resistant germs not only couldn't spread their bad genes, they wound up committing suicide.
"This was a huge surprise," says Redinbo, who now is testing if the approach will work on other bacteria - and is checking his hospital's records to see if women taking osteoporosis drugs just might be less vulnerable to hospital-spread infections.
-Then there are biofilms, where germs literally glue themselves together under a crusty shell difficult for antibiotics to penetrate. Rochester's Koo aims to break up cavity-causing dental plaque, the best known biofilm, with compounds called polyphenols culled from fermented grape skins.
A type of strep bacteria forms dental plaque, by secreting enzymes called GTFs that in turn produces the biofilm's glue. When Koo added polyphenols to lab dishes teeming with strep, GTF production plummeted 85 percent. The germs couldn't get sticky enough. For the record, extracts from Cabernet Franc and Pinot Noir worked best.
The approach should work against strep strains that cause pneumonia, too, Koo says. His ultimate goal is a cavity-preventing rinse, but much more research is required - and Koo warns not to swish with wine in the meantime. It's too acidic.
"You'll wind up with stained teeth and also erosion from the acidity," he cautions.
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EDITOR's NOTE - Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
© 2007 The Associated Press.
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There were even instances in which Florencia 13 leaders ordered killings of black gangsters and then, when the intended victim couldn't be located, said "Well, shoot any black you see," Los Angeles County Sheriff Lee Baca said.
"In certain cases some murders were just purely motivated on killing a black person," Baca said.
Authorities say there were 20 murders among more than 80 shootings documented during the gang's rampage in the hardscrabble Florence-Firestone neighborhood, exceptional even in an area where gang violence has been commonplace for decades. They don't specify the time frame or how many of the killings were racial.
Los Angeles has struggled with gang violence for years, especially during the wars in the late 1980s and early '90s between the Crips and the Bloods - both black gangs. Latino gangs have gained influence since then as the Hispanic population surged.
Evidence of Florencia 13, or F13, is easy to find in Florence-Firestone. Arrows spray-painted on the wall of a liquor store mark the gang's boundary and graffiti warns rivals to steer clear.
The gang's name comes from the neighborhood that is its stronghold and the 13th letter of the alphabet - M - representing the gang's ties to the Mexican Mafia.
Federal, state and local officials worked together to charge 102 men linked to F13 with racketeering, conspiracy to murder, weapons possession, drug dealing and other crimes. In terms of people charged, it's the largest-ever federal case involving a Southern California gang, prosecutors say. More than 80 of those indicted are in custody.
But eliminating the gang won't be easy. It's survived for decades and is believed to have about 2,000 members. Its reach extends to Nevada, Arizona and into prisons, where prosecutors say incarcerated gang leaders were able to order hits on black gangsters.
According to the indictment, F13's leader, Arturo Castellanos, sent word in 2004 from California's fortress-like Pelican Bay State Prison that he wanted his street soldiers to begin "cleansing" Florence-Firestone of black gangsters, notably the East Coast Crips, and snitches.
His followers eagerly obeyed, according to federal prosecutors.
In one case, F13 members came across a black man at a bus stop, shouted "Cheese toast!" and fired. "Cheese toast" is a derogatory name for East Coast Crips, Assistant U.S. Attorney Kevin S. Rosenberg said.
The victim, apparently targeted only because of his skin color, survived being shot several times, Rosenberg said.
F13 isn't the only Latino gang linked to racial killings. Last year, four members of The Avenues, a gang from the Highland Park area east of downtown Los Angeles, were convicted of hate crimes for killing a black man in what prosecutors called a campaign to drive blacks from that neighborhood. And last January, authorities announced a crackdown on the 204th Street gang following the killing of a 14-year-old black girl.
The violence goes both ways, said Adam Torres, a Los Angeles County Sheriff's Department gang detective whose beat includes Florence-Firestone.
During a recent patrol on the east side of the neighborhood, he pointed to a cinderblock wall peppered with bullet holes. Torres said the Crips still control that area and any Hispanic there is at risk of being shot.
Despite the wave of violence, George Tita, a criminologist with the University of California, Irvine, said racially motivated gang killings are an exception. Latinos and blacks are far more likely to be murdered by one of their own.
"You don't see these major black-brown wars, either within the context of gangs or outside the context of gangs," Tita said.
Residents of Florence-Firestone are loath to discuss gangs, fearful they might end up as targets, but there are signs of change. Murders in the neighborhood dropped from 43 in 2005 to 19 in 2006, Baca said. For 2007, there were 19 murders as of Dec. 24.
Jose Garcia sees the difference. The security doors on the store where he works aren't covered with graffiti as often and he hasn't heard a gunshot in two months.
"It used to be at least once or twice a week," he said.
© 2007 The Associated Press.
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