Thursday, March 31, 2011

Bacteria C. Difficile Spores and Klebsiella pneumoniae Resists Last Resort Drugs

Tags: Bacteria Klebsiella pneumoniae C. Difficile Spore Resistant Last Resort Drugs Carbapenem Vaccines Fear Healthy Colon Probiotics Healthy Person

I have noticed in the last several years that more famous people who get the best care in hospitals are dying of pneumonia. It is especially high in New York Hospitals, but has spread to 37 states according to a Scientific American April 2011 article I just read.

Mutated Klebsiella pneumoniae, a gram negative bacteria is especially worrisome because it has transferred this resistant gene to E. Coli which lives in the intestine of every human. It has been extremely hard to eliminate from Intensive Care rooms because the patients urine and feces tend to invariably contaminate the hands and clothes of the healthcare workers and doctors. Even more troubling is that there are apparently healthy carriers of this bacteria.

Recently I had an endoscopy operation to remove an olive from my esophagus. I was horrified that the endoscope sterilization process was not good enough to get rid of the mutated Klebsiella pneumoniae!

Recently I sent information on the difficulty of treating C. Difficile bacteria which produces spores when stressed so the antibiotics often do not work on the spores and release the bacteria when it is safe. Based on the article, a woman who was sure to die when nothing worked, was saved by a desperate attempt by the surgeon of adding healthy feces from her husband into her colon. She regained her health and left the hospital in several weeks. ScienceDaily (Mar. 23, 2011) —

The lesson we all should follow is to do everything possible to keep us as healthy as possible with diet, exercise, and a daily dose of Probiotics from yogurt or individual pills. Costco just started selling them. I have found that fresh organic yogurt did wonders for my digestive system and have not got sick one day from the constantly changing wet and cold weather in Oregon.

A final caution. The Intensive Care unit at my hospital is filled with very sick Flu victims. Don’t believe the anti-vaccine fear scares who rely on the Internet instead of Science. We should require a course in the scientific method in every high school and college. I have never seen so much muddy thinking based on fear than I have seen from extremely intelligent college graduates who are not vaccinating their children.

Jim Kawakami, March 31, 2011,

The Enemy Within: A New Pattern of Antibiotic Resistance by Maryn McKenna, March 22, 2011, A new pattern of resistance has emerged among a particularly challenging group of bacteria called the gram-negatives; it threatens to make many common infections untreatable.

The bacterial genes responsible confer resistance to the carbapenems, a group of so-called last-resort antibiotics. Two of the most important resistance genes are dubbed NDM-1 and KPC.

Carbapenem resistance in gram-negative bacteria is especially worrisome because these germs are ubiquitous and share genes easily. Plus, no new drugs for these bugs are being developed.

This confluence of factors means many people in hospitals and in the wider community could die of newly untreatable infections of the urinary tract, blood and other tissues.

Supplemental Material

Antibiotic Resistance Is Taking Out 'Last-Resort' Drugs Used to Combat Worrisome Category of Germs

In early summer 2008 Timothy Walsh of Cardiff University in Wales got an e-mail from Christian Giske, an acquaintance who is a physician on the faculty of Sweden’s Karolinska Institute. Giske had been treating a 59-year-old man hospitalized that past January in Örebro, a small city about 100 miles from Stockholm. The man had lived with diabetes for many years, suffered several strokes and had lately developed deep bedsores. But those were not the subject of Giske’s message. Instead he was worried about a bacterium that a routine culture had unexpectedly revealed in the man’s urine. Would Walsh, who runs a lab that unravels the genetics of antibacterial resistance, be willing to take a look at the bug?

Walsh agreed and put the isolate through more than a dozen assays. It was Klebsiella pneumoniae, a bacterium that in hospitalized patients is one of the most frequent causes of pneumonia and bloodstream infection. This strain, though, contained something new, a gene that Walsh had never seen before. It rendered the Klebsiella, which was already resistant to many antibiotics used in critical care medicine, insensitive to the only remaining group that worked reliably and safely—the carbapenems, the so-called drugs of last resort. The one medication the investigators found that had any effect on the resistant strain was colistin, a drug that had been out of general use for years because of its toxic effects on the kidneys. Walsh named the enzyme that this gene produced New Delhi metallo-beta-lactamase, or NDM-1, for the city where the man acquired the infection just before he returned home to Sweden. (Full copy on website for subscribers.)

Bacteria Antibiotic Resistance of C. Difficile Enhanced Forms Protective Spores When Stressed which can Reemerge Safe Climate ScienceDaily (Sep. 25, 2007) — Hospitals world-wide battle nosocomial infections on a daily basis. One of the most difficult bacteria to combat is Clostridium.difficile. To help ensure the best control methods possible, Dr. Michael Libman, Director of the Division of Infectious Diseases at the McGill University Health Centre (MUHC), studied the most effective ways to eliminate C.difficile bacteria from the hands of health care workers, with the highest honour going to soap and warm water!

Dr. Libman's team, which included Dr. Oughton, Dr. Vivian Loo, director of the MUHC Department of Microbiology, and Susan Fenn, MUHC assistant Chief Technologist, tested five separate hand washing protocols that emulated hospital conditions as closely as possible. After the hands of the ten volunteers were contaminated with C.difficile, they washed successively with: regular soap and warm or cold water, antiseptic soap and warm water, an alcohol-based solution, and eventually with a disinfectant towel.

"The results were striking: the protocols that involved washing with water eliminated more than 98% of the bacteria, while washing with an alcohol-based solution eliminated almost none! The protocol involving a disinfectant towel eliminated around 95% of bacteria." stated Dr. Oughton.

A characteristic of the bacteria family to which Clostridium difficile belongs is the ability to produce spores when under stress. These spores, which are highly resistant, then produce new bacteria when favourable conditions return. Eliminating them is a major part of the challenge in controlling the bacteria. …

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