*Stomach Bug Mutates Into Medical Mystery*
Antibiotics, Heartburn Drugs Suspected
By Rob Stein
Washington Post Staff Writer
Friday, December 30, 2005; A01
First came stomach cramps, which left Christina Shultz doubled over and
weeping in pain. Then came nausea and fatigue -- so overwhelming she
couldn't get out of bed for days. Just when she thought things couldn't
get worse, the nastiest diarrhea of her life hit -- repeatedly forcing
her into the hospital.
Doctors finally discovered that the 35-year-old Hilliard, Ohio, woman
had an intestinal bug that used to be found almost exclusively among
older, sicker patients in hospitals and was usually easily cured with a
dose of antibiotics. But after months of treatment, Shultz is still
incapacitated.
"It's been a nightmare," said Shultz, a mother of two young children. "I
just want my life back."
Shultz is one of a growing number of young, otherwise healthy Americans
who are being stricken by the bacterial infection known as /Clostridium
difficile --/ or /C. diff/ -- which appears to be spreading rapidly
around the country and causing unusually severe, sometimes fatal illness.
That is raising alarm among health officials, who are concerned that
many cases may be misdiagnosed and are puzzled as to what is causing the
microbe to become so much more common and dangerous.
"It's a new phenomenon. It's just emerging," said L. Clifford McDonald
of the federal Centers for Disease Control and Prevention in Atlanta.
"We're very concerned. We know it's happening, but we're really not sure
why it's happening or where this is going."
It may, however, be the latest example of a common, relatively benign
bug that has mutated because of the overuse of antibiotics.
"This may well be another consequence of our use of antibiotics," said
John G. Bartlett, an infectious-disease expert at Johns Hopkins
University in Baltimore. "It's another example of an organism that all
of a sudden has gotten a lot meaner and nastier."
In addition, new evidence released last week suggests that the enormous
popularity of powerful new heartburn drugs may also be playing a role.
The antibiotics Flagyl (metronidazole) and vancomycin still cure many
patients, but others develop stubborn infections like Shultz's that take
over their lives. Some resort to having their colon removed to end the
debilitating diarrhea. A small but disturbingly high number have died,
including an otherwise healthy pregnant woman who succumbed earlier this
year in Pennsylvania after miscarrying twins.
The infection usually hits people who are taking antibiotics for other
reasons, but a handful of cases have been reported among people who were
taking nothing, another unexpected and troubling turn in the germ's
behavior.
The infection has long been common in hospital patients taking
antibiotics. As the drugs kill off other bacteria in the digestive
system, the /C. diff/ microbe can proliferate. It spreads easily through
contact with contaminated people, clothing or surfaces.convinced I'll
ever be normal again."
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