More than treatments during a hospital stay

Christa Gurriera (11 AM Micro) is concerned about nosocomial infections, and is warning everyone about a recent hospital outbreak due to Klebsiella pneumonia. Those of you who had Klebsiella as an unknown enteric microorganism now know that you should be careful about carrying it home with you. Perhaps you can use this resource as you write your unknown lab report! Here is Christa’s summary:

According to a Newsday article  there was a common nosocomial infection outbreak of Klebsiella pneumoniae. A nosocomial disease or infection is caught in a health care setting by either a patient or staff member. Klebsiella pneumoniae would be considered parasitism because once it’s a pathogen it benefits from its host while harming the host. It is also identified as a Gram negative, rod shaped bacteria which is found in the normal microbiota of the intestines, but is commonly known as a nosocomial disease from a hospital stay.

During this outbreak, despite isolation/quarantine and other techniques to prevent the spread, Klebsiella pneumoniae still managed to continue transmission. The article states that this “began when a 43 year old patient carried a strain of Klebsiella pneumoniae and then went to the U.S. National Institutes of Health’s Clinical Center in Bethesda in June 2011.” It was the cause of much chaos and confusion.

The infection spread to 17 patients within a week throughout the clinical center, making the incidence 17. Out of those patients affected, there were 10 mortalities. This could have been transmitted numerous ways. Indirect and direct patient to patient contact might be a very high possibility. Vehicle transmission could also be a possibility due to the food, water and fomites shared among the staff and patients. The virulence and pathogenicity would also have to be considered to see how this disease was transmitted and how people were diagnosed so quickly. Descriptive epidemiology was used when investigators researched the bacteria to find out and evaluate the cause and how it spread. They collected all the data which included the number of people affected and where it occurred. The U.S National Human Genome Research Institute was able to control the spread within a short time period.

There were case studies administered due to the “outbreak”.  This disease is multi- drug resistant, which raised some issues with finding treatment for the many people influenced by it, and also, made it dangerous for the facility. Most treatments and antibiotics wouldn’t be effective. People with weaker immune systems and diabetes were getting the infection faster than others with more stable and healthy immune systems, because they weren’t able to fight it off and avoid contamination as well. Susceptibility could be due to numerous reasons such as other illnesses that lower their abilities to fight bacteria, age or any types of surgery/procedures that they were admitted into the hospital originally for.

The CDC stated that two of the people who were fortunate enough to avoid infection had the bacteria in their bodies because it is part of their normal microbiota, but it wasn’t causing them any particular harm. This type of symbiosis would be commensalism. This occurs when one member benefits without significantly affecting the other. The Center for Disease Control stated that “1.7 million hospital-associated infections, and 99,000 related deaths, occur each year in the United States.” That’s an alarming number but apparently hospital admitted patients and employees get infected around the globe with nosocomial diseases and should take precautionary measures.

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About ycpmicro

My name is David Singleton, and I am an Associate Professor of Microbiology at York College of Pennsylvania. My main course is BIO230, a course taken by allied-health students at YCP. Views on this site are my own.

Posted on October 29, 2012, in Guest Post, Wash your hands! and tagged , . Bookmark the permalink. 2 Comments.

  1. Ashley Chenoweth

    So could the epidemic be reduced if there more precautions taken by the hospitals? It seems like a very high number of hospital-associated infections. Maybe the medical centers are the beginning of the epidemic, which would explain how an why so many people get infected at once. Most of them go in because they are sick, meaning their immune system isn’t up to par in the first place. It would only make sense that once they begin to feel better, they leave the hospital and then realize that they are infected with another microorganism!

    • Transmission in the outbreak was not understood prior to genetic analysis of patient isolates. The original manuscript in the journal Science Translational Medicine indicates that the outbreak originated from a single infected patient, however not all transmission events resulted in overt disease, and it also took a relatively long window of incubation prior to appearance of signs and symptoms. Take home message: standard methods of infection control can be effective, but because you may not immediately see results of transmission, you may not be able to put the right patients into isolation.

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