An Approach to Preventing the Nightmare Bacteria
Frontline recently released a documentary called “Hunting the Nightmare Bacteria.” It details the accounts of three separate stories, happening in completely different parts of the world at the same time. All of these stories are connected by one thing: potentially deadly bacteria with no treatable medicines. Below is a very basic summary of the documentary along with a key takeaway from a disinfection standpoint.
The documentary can be seen in its entirety through the PBS website here. If you have the time to watch this documentary, I would highly recommend it.
It all begins with a seemingly surreal scene where a completely healthy 11 year old girl suddenly becomes ill. She starts out with some basic symptoms that seem innocent enough, such as headaches and a fever, but the illness quickly progressed, putting her on the cusp of phenomena and something even worse. See, Addie did as most children do and picked at some scabs that she had. The doctors realized that these cuts had exposed her body to dangerous bacteria, and she had developed Community MRSA. Unfortunately, the bacteria had reached her blood and she needed to be put on an ECMO machine.
Things quickly went from bad to worse. A very disheartening truth is that the tubes used in an ECMO machine can never be 100% safe. No matter how well hospitals clean out the tubes, some harmful bacteria have the ability to linger until the equipment is reused and enters another patient body. Addie’s ECMO machine was one of the rare cases where a dangerous pathogen had lingered, and a strain of Stenotrophomonas bacterium had entered her body. Unfortunately there are only 3 or 4 known working antibiotics that can treat this type of infection. Fortunately, with a strong effort from Addie and her doctors, she was able to pull through. Unfortunately, Addie’s immune system will never completely recover from this infection, leaving her extremely vulnerable to dangerous infections.
Now at the same time, halfway across the country, an eerily similar scenario was taking place in a hospital setting. The Clinical Center at the National Institute of Health (NIH) was in the middle of one of the worst bacteria outbreaks that they’ve ever seen. They were dealing with the antibiotic-resistant KPC, which has the ability to spread its gene to other bacteria. This bacterial outbreak had started back in 2011 when a patient carrying KPC was transferred from a New York hospitals to NIH in Maryland. Understanding the devastation that could be unleashed if the bacteria spread, the hospital created a special section in the ICU just for this patient.
Per standard protocol, the doctors and nurses washed their hands and cleaned the machines and equipment. They regularly tested the patients to ensure that the KPC was contained. Within 4 weeks, the results showed that the original patient had recovered and all other patients were testing negative for KPC.
But then it happened. Several weeks after the original carrier of KPC left, an ICU patient was diagnosed with KPC. Then another, and another, and another – all from ICU! NIH created a special area dedicated to the infected patients. Then, one of their biggest nightmares came true, and they found a patient from the general hospital population had KPC.
The hospital performed tests for weeks, trying to find what these patients had in common, but to no avail. What the tests did show was that some of their patients were silent carriers. This meant that the KPC could spread through the hospital undetected, making the treatment that much more difficult. As quickly as this outbreak appeared, the KPC seemed to vanish. Unfortunately, by the time the hospital was able to contain this breakout, 18 people ended up being treated for KPC and six passed away.
To this day, the hospital still believes that the KPC bacteria is still inside the building. They remain ever vigilant to their standard safety protocols and consistently wash their hands, wear masks, and clean all medical equipment.
Takeaway
This gripping Frontline documentary shows just how easy it is for bacteria to linger and spread in a clinical setting. It also demonstrates how a simple outbreak in a community setting is mimicked proportionally by hospitals. All it takes is one infected individual to put the entire clinical community at risk. Stories such as these are tragic, but they are a very real concern in today’s healthcare environment.
In order for hospitals to minimize the potential for these dangerous outbreaks, it is critical that clinicians adhere to their cleaning and disinfection policies. Hand washing and basic cleaning alone are not always enough to neutralize the dangerous bacteria that can linger on surfaces. Proper disinfection, which includes adhering to all printed label instructions, is the only way to ensure that events like those detailed in this documentary do not repeat themselves.
About the Author
David Engelhardt has over 26 years of experience in software and hardware solutions development in healthcare and manufacturing, with a particular focus on mobile technologies. David is the founder and President of ReadyDock Inc. He is passionate and committed to providing safe, and workflow efficient methods to enable clinicians and patients to enhance care through the use of innovative technologies. In the small window of time when he is not working or spending time with his amazing wife and daughter, he spends his time playing USTA tennis, collecting vinyl records, and shaping music and sound in his recording studio.
References
PBS Frontline. (Producer). (2013, October 22). Hunting the Nightmare Bacteria [Web Video]. Retrieved from http://www.pbs.org/wgbh/pages/frontline/hunting-the-nightmare-bacteria/