COOTIE CONCERNS; CASHING IN ON NATION'S PHOBIA, TODAY'S ANTIBACTERIAL ARSENAL NO BETTER THAN BASIC SOAP, WATER.

Byline: Phil Davis Daily News Staff Writer

Mom was right to insist on all that hand washing, but a parental obsession with eradicating germs may be giving bacteria the upper hand.

According to the national Centers for Disease Control and Prevention, middle class mommies' and daddies' insistence on unnecessary drugs to treat junior's sore throat played a significant role in the emergence of antibiotic-resistant strains of bacteria, ``superbugs'' that shrug off drugs that used to be hailed as a medical miracle.

The next bacterial battleground: America's kitchens and bathrooms.

A plethora of new antibacterial cleaning products, soaps and hand lotions that hit grocery-store shelves in recent years are cashing in on America's germ worries.

But scientists say the new products are, at best, as effective and brutal as pruning a rose bush with a chainsaw.

At worst, they could lead to the evolution of new superbugs.

``It's overkill,'' said Patricia Lieberman, a staff scientist with the public health watchdog group Center for Science in the Public Interest (CSPI). ``For most healthy individuals, killing all the bacteria shouldn't be the goal.''

Dr. David Pegues, an infectious-disease expert and professor at UCLA Medical Center in Los Angeles, agreed.

``There is no clear benefit for using (antibacterial products) over plain old soap and water,'' he said. ``It's not quite as serious a transgression as misusing antibiotics, but it does remain a theoretical concern.''

For a decade, scientists and physicians have watched bacteria grow stronger as their once mighty antibiotics arsenal became increasingly less effective.

Most strains of bacteria that cause ear infections and meningitis in children had developed almost a complete resistance to penicillin by the 1970s - only 40 years since the discovery of the so-called ``miracle drug.''

Last year, three Americans in different locations were infected with a staph infection that was immune to vancomycin, medicine's last line of antibiotic defense against the potentially deadly bacteria. The patients survived, but the close call gave doctors a genuine scare.

``We've had antibiotics for less than 60 years,'' Pegues said. ``Bacteria have been evolving for a millenia. So, the reality is we were unduly optimistic we could win the war against drug-resistant bacteria simply by synthesizing and developing new antibacterial compounds. We will never win that battle.''

The blame for this crisis falls to doctors for overprescribing the drugs; consumers for overuse and misuse; and to beef, poultry and pork manufacturers for using antibiotics to accelerate the growth of livestock.

Last week, CSPI called on the FDA to ban the use of antibiotics to fatten livestock because several studies show that people who eat the meat also are ingesting antibiotic-resistant bacteria.

The industries use more than a third of all antibiotics sold in the United States.

``There is reason to be alarmed,'' said CSPI's Lieberman. ``Does it make sense to use these precious drugs to make animals grow faster? No. And you may be sicker because of it. Some pathogens - like E. coli and salmonella - have gotten stronger and sometimes more deadly. Consumers should get safe, clean, wholesome food. They shouldn't have to worry.''

The CDC and the World Health Organization have echoed the center's concerns.

One study found the prevalence of salmonella typhimurium food poisioning infections resistant to antibiotics soared from 1 percent in 1979 to 34 percent in 1996. And, in Denmark, a 1995 ban on the use of an antibiotic to promote growth in chickens resulted in a 70 percent decline in antibiotic-resistant enterococci in only a few years, the CSPI reported.

Ironically, these superbugs and highly publicized maladies such as flesh-eating bacteria or mad cow disease are a driving force behind the marketLing of antibacterial soaps and lotions. Most of the products contain chemicals such as triclosan or triclocarbon, which kill bacteria instead of simply washing it off like regular soaps. Unlike antibiotics, which target a specific bacteria, agents like triclosan kill everything.

``It's like an atom bomb - it kills indiscriminately,'' said Dr. Arleen Rockoff, chief of medicine at Kaiser Permanente Medical Center in Woodland Hills.

Among the potential casualties: millions of ``good'' bacteria that keep away bad germs through healthy competition for living space.

This heavy-handed approach to housecleaning also leads to some domestic Darwinism - only the strongest germs survive. And since bacteria have the remarkable ability to absorb useful parts of other bacteria, if the survivors are from the bad minority, it's possible the organisms will pass on an immunity to the next generation. Bacteria are very sharing organisms.

That's still a theory. But the possibility drew concern from Dr. Stuart Levy, a leading authority on antibiotic-resistant bacteria at Tufts New England Medical Center in Boston. In a recent article in Scientific American magazine, Levy called the antibacterial fad in home cleaning products ``a new threat.''

His advice: Save the heavy-duty antibacterial cleaners for emergencies, such as when a person is coming home from the hospital or to clean homes where someone has a compromised immune system.

Everyone agrees the best way to beat bad bacteria is to wash your hands.

``First and foremost, we emphasize hand washing thoroughly, which means 15 to 20 seconds on a regular basis,'' said Janet Donohue, a spokeswoman for the New York-based Soap and Detergent Association. ``The particular soap you use is really consumer choice. When it comes to antibacterial handwash products, we think they provide a certain level of comfort to the consumer.''

Doctors say plain old soap and warm water work just as well. In hospitals, antibacterial soaps are used only in the mostL sterile environments - surgical suites and the neonatal intensive care unit.

``Soap actually physically removes contaminants. It lifts them so they can be rinsed off,'' said UCLA's Pegues. ``It's as effective as these disinfectant and antiseptic products, which kill the micro-organisms.''

Just rinsing won't work, though. Hands should be thoroughly lathered for at least 15 seconds - about the time it takes to sing one verse of ``Rub a dub dub,'' Pegues said. Then the germs will just slide off.

THE WAR ON BACTERIA

Scottish scientist Alexander Fleming accidentally discovers penicillin in 1928. This ``miracle'' drug saves countless lives from bacterial infections. There are now 160 antibiotics and 13 in development.

After widespread use in the 1940s, physicians begin to notice bacteria developing resistance to antibiotics. But rapid development of new drugs eliminates any concern. During the next four decades, America's production of antibiotics swells from 2 million to 50 million pounds a year.

In the 1970s, scientists find strains of bacteria that have developed an almost complete resistance to penicillin.

As drug companies divert antibiotic research resources to battle HIV and other health threats in the early 1980s, Harvard scientists link an outbreak of antibiotic-resistant Salmonella in humans to beef cattle fed with chlortetracycline to increase their growth rate.

In 1995, the CDC begins a national campaign to curb antibiotic abuse.

Two years after the FDA approves the use of flouroquinolone antibiotics to prevent E. coli infection in poultry - despite objections from the Centers for Disease Control and Prevention - a preliminary 1997 report finds growing resistance to the antibiotic in chickens, turkeys and humans.

A 1997 Center for Science in the Public Interest study finds as many as 40 percent of pneumococcus bacteria strains are resistant to common antibiotics - compared to none a decade earlier. Meanwhile, manufacturers introduce antibacteLrial soaps and lotions, prompting concern that kitchens and bathrooms could be the next breeding ground for mutated bacteria.

In 1998, three Americans infected with hospital-acquired staph infections are found to be resistant to vancomycin, the last line of defense against the potentially lethal infection. Scientists hail the cases as more proof that antibiotic abuses are one step closer to breeding an unstoppable killer bacteria strain.

Sources: Center for Science in the Public Interest in Washington, D.C., and the Tufts University Center for Adaptation Genetics and Drug Resistance in Boston.

CAPTION(S):

2 Photos, Box

PHOTO (1--Color--Cover) Germ warfare

Are antibacterial products doing us more harm than good?

David Sprague/Daily News

(2) In hospitals, antibacterial soaps are used only in the most sterile environments - surgical suites and the neonatal intensive care unit.

Michael Owen Baker/Daily News

BOX: THE WAR ON BACTERIA (See text)