If superbugs could talk, they’d be pleading with us to please use cigarettes; and while they’d prefer us to smoke regular cigarettes, e-cigarettes will do just fine, thank you very much.

While this is not the verbatim conclusion of recent research conducted at the VA San Diego Healthcare System (VASDHS) and the University of California, San Diego (UCSD), the message is clear. Add another reason to cross both regular cigarettes and e-cigarettes off your list of habits: They make drug-resistant bacteria stronger.

The researchers set out to examine the effects of e-cigarette vapor on live methicillin-resistant Staphylococcus aureus or MRSA. MRSA is an unruly bacteria that is resistant to many antibiotics; it most often thrives in skin infections. In medical facilities, MRSA causes life-threatening bloodstream infections, pneumonia and surgical site infections, according to the Centers for Disease Control and Prevention.

Lead investigator Laura E. Crotty Alexander, MD, and her team grew MRSA in culture. When they exposed it to e-cigarette vapor equivalent to what is available on the market, the virulence of the bacteria was increased by changing the surface of the MRSA in a way that made it less vulnerable to attack.

By providing greater resistance to attack from human cells and antibiotics, the bacteria is better able to create infection in the body and cause more devastating disease.

And while e-cigarette vapor increased bacterial vigor, the team found that the vapor also decreased the ability of human epithelial cells to kill pathogens. The vapor makes the bacteria stronger and also weakens the body's resources to fight it.

But e-cigarette users shouldn’t take this to mean that regular cigarettes are any better when it comes to empowering superbugs. In parallel studies carried out by the researchers, cigarette smoke made the bacteria even more aggressive.

They found that when MRSA was exposed to regular cigarette smoke, surface changes to the bacteria were 10-fold greater than that of e-cigarette vapor. In looking at pneumonia models, cigarette smoke-exposed MRSA had four-times greater survival in the lungs than the regular MRSA, while e-cigarette vapor-exposed MRSA had a three-fold higher survival.

"As health care professionals, we are always being asked by patients, ‘Would this be better for me?’” Alexander said. "In the case of smoking e-cigarettes, I hated not having an answer. While the answer isn't black and white, our study suggests a response: even if e-cigarettes may not be as bad as tobacco, they still have measurable detrimental effects on health."

The study was presented at the 2014 American Thoracic Society International Conference.

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