What are Superbugs? A HealthCentral Explainer

UPDATED 3/6/2013:

Superbugs sound like they should be characters in a comic book, but, in fact, they are real-life bacteria that have become increasingly resistant to antibiotics. Hospitals and nursing homes used to be the only places where they seemed spread, but more recently, outbreaks have been traced to gyms and day care centers.

What was the first superbug?

Methicillin resistant Staphylococcus aureus (MRSA) was first seen by U.S. doctors in the 1960s, when patients at hospitals were diagnosed with staph infections that were resistant to antibiotics. Until the  1990s,, doctors believed that MRSA was only present in hospitals where patients were ill and couldn’t fight off the infection,  Maryn McKenna, author of Superbug: The Fatal Menace of MRSA, pointed out in  an NPR interview.

But then  young patients began showing up at the University of Chicago Medical Center’s emergency room with severe cases of MRSA, which they hadn’t contracted in hospitals. Researchers realized there was a slightly different strain that had adapted to live outside a hospital. At first, it was resistant to fewer drugs than the hospital strain, but quickly became resistant to more antibiotics. Now, the hospital strain and the community strain have merged to create a third strain, which is even more dangerous, according to McKenna.

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Have there been more recent outbreaks?

Last year, the National Institutes of Health (NIH) Clinical Center dealt with a superbug outbreak, which infected 17 people and left six dead--five others who were infected died, but not directly from the superbug. This superbug was called Carbapenem-resistant Klebsiella pneumonia (CRKP), and can cause pneumonia, bloodstream infections, wound site infections and meningitis.

The superbug was brought into the hospital by a 43-year-old woman who was already infected. Aggressive efforts were made to contain the superbug so that it did not spread throughout the hospital.  The woman was put in an isolated intensive care room, where doctors used masks, gloves and gowns every time they interacted with her.  Throughout her treatments, everything was sterilized or treated as infectious waste. Despite these efforts, however, the superbug spread.

To address the problem, the hospital ripped up plumbing, sterilized rooms and used a new technology called Whole Genome Sequencing that allowed them to decipher the genetic code of the bacteria. They were then able to trace the pattern of how the superbug spread, and found that it had lingered in certain equipment and sink drains.

Maryn McKenna and several other infectious disease experts have pointed out that these infections are happening in hospitals and nursing homes all over the country. Few of them have the same resources as the NIH to track and fight outbreaks.

UPDATE:  A new report from the Centers for Disease Control and Prevention has found that of all the infections caused by gut bacteria, the types that are carbapenem-resistant (a last resort antibiotic) rose from 1 percent in 2001 to 4 percent in 2012. Among infections caused by Klebsiella, 10 percent have become resistant, while just a decade ago only 2 percent were resistant.

Experts also noted that when certain bacteria enter parts of the body they don't belong, such as the bloodstream, lung or urinary tract, the infection may become untreatable. Even more frightening, these bacteria are capable of passing their drug-resistant trait to other bacteria.

What other superbugs are out there?

Aside from MRSA and CRKP, several other strains of bacteria are becoming antibiotic-resistant.  Four other hospital bacteria have infected people through the use of surgical implants and other equipment, according to ABC News.

Food-borne bacteria, such as e coli and salmonella, which cause food poisoning, are becoming drug resistant in part due to how many antibiotics are being fed to farm animals to prevent infection and further growth.

Sexually transmitted diseases are also becoming an issue. Super gonorrhea and chlamydia are on the rise, and may now require more invasive treatments. As antibiotics become less effective, intravenous or intramuscular treatments could become necessary.

Globally, tuberculosis is also becoming resistant to multiple drugs. Of the 12 million cases in the world, the World Health Organization believes that 650,000 are from drug-resistant strains.

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How did this happen?

Several factors are at play when it comes to antibiotic resistance. Misuse of antibiotics is one of the main problems--either taking antibiotics too often for unnecessary illness - such as colds, flu bronchitis, cough, ear infections and most sore throats – or not taking the full course of antibiotics when prescribed. This can leave remaining bacteria in the body that can adapt and become more resistant to drugs and then spread to other people. When bacteria become resistant to first-line treatments, costs of care increase, along with risks and complications.

Farm animals being fed antibiotics to prevent infection and promote growth are also a problem. When bacteria survive in these circumstances, it can out-populate other strains, ensuring that resistant bugs can spread more easily, according to CNN.

Have researchers found new treatments?

A new study recently published in the Journal of Clinical Investigation looked at the ability of vitamin B3 to help the immune system kill antibiotic-resistant staph bacteria. Researchers did lab work on mice and human blood, and found that vitamin B3 increased the immune cell’s ability to kill the bacteria by 1,000 times, according to Medical News Today.

Researchers say they might be able to combine the vitamin with antibiotics to create a lethal combination for staph infections.


n.p. (2012, August 28). “Vitamin B3 May Help Kill Superbugs”. Medical News Today.  Retrieved from http://www.medicalnewstoday.com/articles/249511.php.

n.p. (2012, August 23). “NIH Takes Extraordinary Steps in Fighting ‘Superbug.’” NPR. Retrieved from http://www.npr.org/2012/08/23/159931389/nih-takes-extraordinary-steps-in-fighting-superbug?ft=1&f=1128&sc=tw

Moisse, Katie. (2012, March 27). ABC News. “Antibiotic Resistance: The 5 Riskiest Superbugs.” Retrieved from http://abcnews.go.com/Health/Wellness/antibiotic-resistance-riskiest-superbugs/story?id=15980356#.UD4i1KAgmF8

Szalavitz, Maia. (2012, August 30). “Outbreak of NIH ‘superbug’ provides valuable lessons.” Retrived from http://www.cnn.com/2012/08/30/health/time-superbug-lessons/index.html