BIOL 191 Introductory Microbiology

Hunting the Nightmare Bacteria (Frontline Oct. 2013 54:11)

Addy

  1. What did doctors believe Addy was infected with initially? What were her symptoms?

Thought it was Staph- with septic shock

Pain in hip, pain spread, fever, decreased bp, pneumonia, boils, lung transplant

  1. Addy had ‘community-acquired’ resistant staph (as opposed to hospital-acquired). How did Addy likely become infected initially? Picked at a scab
  2. What secondary infection did Addy acquire in the hospital? How did she acquire it?

Breathing tubes are invasive, can live inside the breathing tube

Stenotrophomonas(opportunistics pathogen. Gram negative bacillus)- only 4-5 antibiotics that can treat it.

  1. What does pan-resistant mean? Resistant to everything (pan is Greek meaning every) however, it is often misused in the literature and confused with MDR (multiple drug resistant) or XDR (extreme drug resistance)
  2. Why are Gram negative bacteria often more difficult to treat? They have an ‘armor’ that surrounds the bacteria-more difficult for the antibiotic to get inside
  3. What have been the lasting effects of Addy’s infections? Lung transplants (only 50% make it after 5 years), pills, more pneumonia

David

  1. How was David Ricci injured in India. He was infected with CRE (carbapenem-resistant enterobacteriaceae). What gene invokes this type of resistance? hit by a train.NDM-1 gene
  2. Are bacteria with the NDM-1 gene found in the environment? Yes. They can pass on this resistance to other bacteria here
  3. About how many other types of resistant bacteria did they find? About 5
  4. If a spreading infection cannot be cured, what has to happen? Surgical removal of infected tissue

Clinical Center at the National Institutes of Health (NIH)

  1. Where do many Gram negative bacteria live in the body? Digestive system
  2. In 2008, a patient in ICU was diagnosed with KPC (Klebsiellapnuemoniaecarbapenemase-producing) at the Clinical Center at the National Institutes of Health (NIH). Five weeks after the patient was released, KPC turned up in a respiratory culture. Do they know how it was spread? Were they able to get rid of it at that time? Don’t know how it was spread or if it was a second completely isolated introduction. They found other patients that were infected with it. Started identifying a patient a week. Found silent carriers – it was all over the hospital before the outbreak.
  3. Six months after patient #1, there was another outbreak. How many patients were infected and how many died? 18 patients, 6 died (Me? In 2012, another patient died there from it)

Antibiotics

  1. The more antibiotics are used, the more they become.
  2. Alexander Fleming, the discoverer of penicillin saw resistance as early as 1945
  3. Up to ½ of antibiotic use is inappropriate.
  4. Why is it more lucrative for drug companies to develop drugs for chronic illnesses than antibiotics? People only use antibiotics for a short time until they are cured. People use drugs for chronic diseases for years.
  5. Approximately how much does it cost to bring a new drug to market? #600 million-billion
  6. The CDC estimates:
  1. Number of people infected with resistant bacteria? 2 million
  2. Number of people that have died? 23,000 (more than AIDS- must be US number)

In March 2013, The CDC finally raised the alarm about antimicrobial resistance. March 2013, Obama put $60 million in the resistance program in the proposed budget (doubled the funding)