December 21, 2007
Friday AM

In the war between killer bugs and humanity, Pat Schlievert is one of the generals.

As slender and energized as a live wire, the University of Minnesota microbiologist knows more about staph than just about anyone. That's why each day he fields phone calls and e-mails from doctors around the country seeking his help in figuring out if and how staph is making their patients sick.

Last month Schlievert's 30-year war on staph hit the headlines. A Centers for Disease Control and Prevention study put the public on notice that a staph variety known as methicillin-resistant saphylococcus aureus, or MRSA, belongs in the realm of superbugs to be feared.

The CDC study showed the increasingly antibiotic-resistant bacteria were running rampant in hospitals and nursing homes, and are increasing among otherwise healthy people. Researchers estimated that nationwide it contributed to the deaths of 19,000 people in 2005.

Schlievert says that number is vastly underestimated, a testament to how the organism outwits even scientists. Nor is he optimistic about staying one step ahead of it. He has come to regard his bacterial nemesis as a remarkably ingenious life form, evolving to resist humanity's best weapons.

"It keeps making new things," Schlievert said. "And it will continue in this never-ending battle in how to outdo us."

So far, Schlievert has proved a potent adversary. He figured out how staph cleverly deploys toxins to hijack the body's immune system, and he has seen how it swoops in behind flu virus to roost in weakened lungs.

Mike Osterholm, now director of the Center for Disease Research and Policy at the university, once gave Schlievert the ultimate compliment. Pat, he said, you think like a microbe.

At the time they were trying to solve one of the biggest modern-day health mysteries -- toxic shock syndrome.

In the early 1980s, toxic shock was a mysterious, rare but terrifying disease. For reasons no one could explain, some menstruating women would develop high fevers, rashes and a dangerous drop in blood pressure. Thousands of cases were reported, including dozens of deaths.

Many of the early cases were identified in Minnesota, where Osterholm was the state epidemiologist and Schlievert was a young assistant professor at the university.

The two things the women had in common when they got sick were their periods and staph bacteria in their vaginas -- but not in their blood or elsewhere inside their bodies.

The CDC was quick to blame a new type of super-absorbent tampon called Rely. Its maker, Procter & Gamble, pulled it from the market.

Both Osterholm and Schlievert thought there was more to it than the tampon. Between 1981 and 1983, Schlievert was one of the key researchers who proved it.

Half of the population carries staph in or on their bodies, usually inside their noses. Though the bug can cause nasty boils and other skin infections, it generally wasn't considered dangerous to healthy people -- unless it had the right conditions. Schlievert showed those conditions existed inside the vagina of a menstruating woman with lots of oxygen provided by a tampon, even more so with super-absorbent tampons.

Under those circumstances -- and only in some people who were susceptible -- the bacteria produced a toxin so powerful that a microscopic amount could kill. Even though the bacteria never entered the body, the toxin could penetrate the lining of the vagina and put some women in shock.

It was a new concept," said Dr. Frank Cerra, the university's senior vice president for health sciences. "That you would have bugs growing in a tampon that would release a toxin -- a toxic shock in the absence of an infection. It was controversial."

But really, Schlievert said, all he had to do was think like a microbe.

"If I was doing this, how would I do it? I would be the most common microbes and make people think I'm not doing anything. That's what I would do."

That was nearly 30 years ago. Now Schlievert, 58, is one of the world's experts on toxins that some strains of staph produce and how they overwhelm the body's immune system.

Schlievert says he believes that staph is the culprit in many more deaths than it gets credit for. He thinks that it will continue to outsmart doctors and researchers unless the federal government funds more research into how it resists antibiotics, and how it hijacks the immune system.

And he's working on some new weapons himself. The university has patented a product he has devised with other researchers that he hopes can be used to block the toxins that the bacteria produce. In the meantime, staph's ability to adapt and change to produce new diseases provides Schlievert with an endlessly fascinating quest.

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