from the no-need-to-spread-the-word-but-okay-to-let-the-disease-spread? dept.
Submitted via IRC for AzumaHazuki
Deadly germs, Lost cures: A Mysterious Infection, Spanning the Globe in a Climate of Secrecy [Editor's Comment: Link has disappeared.]
https://www.nytimes.com/2019/04/06/health/drug-resistant-candida-auris.html [Alternative Link]
Last May, an elderly man was admitted to the Brooklyn branch of Mount Sinai Hospital for abdominal surgery. A blood test revealed that he was infected with a newly discovered germ as deadly as it was mysterious.
Doctors swiftly isolated him in the intensive care unit. The germ, a fungus called Candida auris, preys on people with weakened immune systems, and it is quietly spreading across the globe.
Over the last five years, it has hit a neonatal unit in Venezuela, swept through a hospital in Spain, forced a prestigious British medical center to shut down its intensive care unit, and taken root in India, Pakistan and South Africa .
Recently C. auris reached New York, New Jersey and Illinois, leading the federal Centers for Disease Control and Prevention to add it to a list of germs deemed "urgent threats."
The man at Mount Sinai died after 90 days in the hospital, but C. auris did not. Tests showed it was everywhere in his room, so invasive that the hospital needed special cleaning equipment and had to rip out some of the ceiling and floor tiles to eradicate it.
"Everything was positive — the walls, the bed, the doors, the curtains, the phones, the sink, the whiteboard, the poles, the pump," said Dr. Scott Lorin, the hospital's president. "The mattress, the bed rails, the canister holes, the window shades, the ceiling, everything in the room was positive."
[...] In the United States, two million people contract resistant infections annually, and 23,000 die from them, according to the official C.D.C. estimate. That number was based on 2010 figures; more recent estimates from researchers at Washington University School of Medicine put the death toll at 162,000. Worldwide fatalities from resistant infections are estimated at 700,000.
[...] With bacteria and fungi alike, hospitals and local governments are reluctant to disclose outbreaks for fear of being seen as infection hubs. Even the C.D.C., under its agreement with states, is not allowed to make public the location or name of hospitals involved in outbreaks. State governments have in many cases declined to publicly share information beyond acknowledging that they have had cases.
All the while, the germs are easily spread — carried on hands and equipment inside hospitals; ferried on meat and manure-fertilized vegetables from farms; transported across borders by travelers and on exports and imports; and transferred by patients from nursing home to hospital and back.
C. auris, which infected the man at Mount Sinai, is one of dozens of dangerous bacteria and fungi that have developed resistance. Yet, like most of them, it is a threat that is virtually unknown to the public.
[...] Dr. Lynn Sosa, Connecticut's deputy state epidemiologist, said she now saw C. auris as "the top" threat among resistant infections. "It's pretty much unbeatable and difficult to identity," she said.
Nearly half of patients who contract C. auris die within 90 days, according to the C.D.C. Yet the world's experts have not nailed down where it came from in the first place.
'No need' to tell the public
Under her [Dr. Johanna Rhodes, an infectious disease expert at Imperial College London] direction, hospital workers used a special device to spray aerosolized hydrogen peroxide around a room used for a patient with C. auris, the theory being that the vapor would scour each nook and cranny. They left the device going for a week. Then they put a "settle plate" in the middle of the room with a gel at the bottom that would serve as a place for any surviving microbes to grow, Dr. Rhodes said.
Only one organism grew back. C. auris.
It was spreading, but word of it was not. The hospital, a specialty lung and heart center that draws wealthy patients from the Middle East and around Europe, alerted the British government and told infected patients, but made no public announcement.
"There was no need to put out a news release during the outbreak," said Oliver Wilkinson, a spokesman for the hospital.
This hushed panic is playing out in hospitals around the world. Individual institutions and national, state and local governments have been reluctant to publicize outbreaks of resistant infections, arguing there is no point in scaring patients — or prospective ones.
Related Stories
University of Sheffield and Rutherford Appleton Laboratory (RAL) scientists have discovered several new related (dinuclear RuII) compounds which visualize and kill gram-negative bacteria, such as E. coli (note - no word on whether it works on synthetic E.coli)
Bacteria are classified generally by what type of staining works on them using a method developed in the 1800's by Hans Christian Gram. 'Gram-negative' bacteria retain a stain color that shows them as a pinkish red coloring, these bacteria have cell walls that make it difficult to get drugs into them and many gram-negative bacteria have become significantly or even completely resistant to available drug treatments.
A new drug in the difficult gram-negative space is particularly important. Drug resistant bacteria already cause the deaths of over 50 thousand people a year in the US and EU alone, and as many as 10 million people a year could die worldwide every year by 2050 due to antibiotic resistant infections.
Doctors have not had a new treatment for gram-negative bacteria in the last 50 years, and no potential drugs have entered clinical trials since 2010.
The new drug compound has a range of exciting opportunities. As Professor Jim Thomas explains: "As the compound is luminescent it glows when exposed to light. This means the uptake and effect on bacteria can be followed by the advanced microscope techniques available at RAL.
"This breakthrough could lead to vital new treatments to life-threatening superbugs and the growing risk posed by antimicrobial resistance."
The studies at Sheffield and RAL have shown the compound seems to have several modes of action, making it more difficult for resistance to emerge in the bacteria.
Better yet
Mammalian cell culture and animal model studies indicate that the complex is not toxic to eukaryotes, even at concentrations that are several orders of magnitude higher than its minimum inhibitory concentration (MIC).
The researchers plan to test the compounds against additional multi drug resistant bacteria next.
(Score: 1, Funny) by Anonymous Coward on Wednesday April 17 2019, @07:36AM (7 children)
Also known as yeast. Just dry the room out thoroughly and treat the infection with a strong anti-fungal agent. Bleach in a strong enough concentration will kill this shit.
(Score: 2, Funny) by Anonymous Coward on Wednesday April 17 2019, @07:43AM (5 children)
You've done it! Found a cure for C. auris infections! You'll get a Nobel Prize for this!
Anyone found with the infection should just be injected with a bleach solution with a high enough concentration to kill it
Just to make sure, we should probably have the patient drink such a solution as well.
You've saved us all!
(Score: 2) by c0lo on Wednesday April 17 2019, @07:48AM
Oy! Needs to be desiccated first!
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
(Score: 0) by Anonymous Coward on Wednesday April 17 2019, @09:06AM (1 child)
Well, when applying that cure, the patients surely won't die from the infection. ;-)
(Score: 2) by bob_super on Thursday April 18 2019, @12:36AM
For the same end result, setting the patient on fire would be better, through helping reduce the hospital's heating bills.
(Score: 2) by Gaaark on Wednesday April 17 2019, @10:41AM (1 child)
Don't worry, dark matter enthusiasts will have this covered in 3...2...1...
--- Please remind me if I haven't been civil to you: I'm channeling MDC. ---Gaaark 2.0 ---
(Score: 0) by Anonymous Coward on Wednesday April 17 2019, @01:39PM
Dark matter is easy to proof. Universes without dark matter don't contain systemd.
And yes, this post is exactly as on-topic as the one I replied to.
(Score: 0) by Anonymous Coward on Thursday April 18 2019, @12:24AM
they tried that: spraying "aerosolized hydrogen peroxide" aka bleach around the room. It didn't work.
next idea?
(Score: 2, Funny) by c0lo on Wednesday April 17 2019, @07:45AM
Climate of Seeeecrecy... sushhhh
Almost can't believe it has been more than 15 years ago. [wikipedia.org]
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
(Score: 1) by Coward, Anonymous on Wednesday April 17 2019, @08:12AM (2 children)
This is just a question, and I'm not saying the medical community is wrong: With all the talk of drug resistant bacteria, are there studies that show withholding antibiotics from patients, or reducing the course/dosage helps? I've had a doctor tell me that the more antibiotics we take, the more our bodies get colonized by resistant strains. But is that actually known to be true?
I mean, the theory is plausible that antibiotics don't work against all germs because of human influence, but is there hard evidence that this occurs outside the Petri dish? Nature is a vast reservoir, and it may be incorrect that humans change the prevalence of drug-resistant germs.
The anecdotes of "we never saw this kind of drug-resistant infection before, but now we get them all the time" could also be explained by changes in standards of care and enhanced diagnostic capabilities.
I see this ResistanceMap [cddep.org], but it includes the disclaimer:
So geographic correlation between antibiotic resistance and usage seems pretty useless.
(Score: 2) by opinionated_science on Wednesday April 17 2019, @12:03PM (1 child)
It is the *incomplete* use of antibiotics that causes resistance.
Antibiotics do not completely kill the bacterium, except in a petri dish, or in really high doses (for patients with compromised immune systems).
The use of antibiotics means that your immune system will have time to respond to a weakened infection, rather than the metabolic load cause by replication damage.
However, if you stop taking the antibiotics before the immune system has clear the infection, there will be some colonies that may have evolved a resistant mutation.
Do this often enough in a society, and the variant of an infection you get, may be one that has acquired such a mutation.
(Score: 2) by HiThere on Wednesday April 17 2019, @04:17PM
Eeeehhhhh.....no...or only partially.
Incomplete use of antibiotics allows strains with marginal immunity to survive, and those often mutate into one fully immune to that particular treatment. But it actually helps those that are already sufficiently immune.
Also, most antibiotics are slight modifications of weapons used by soil bacteria, so there's already a source of "disposition to immunity". And bacteria share genes between "species". (What species means in a "species" that reproduces by dividing and without using sex is a bit vague.)
That said, antibiotic using humans are a fertile breeding ground for variant micro-organisms that are resistant to those antibiotics. And we've provided a large pool. (This is also true for chicken, steers, pigs, etc.) If you use enough antibiotics to kill off all those that have infected you, THAT colony will die. But this doesn't mean it hasn't left descendants from part way through your treatment, that have already been selected for partial immunity.
So it's a lot more complicated than the normal way the papers report it.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 3, Insightful) by shrewdsheep on Wednesday April 17 2019, @08:14AM (6 children)
If the germ was readily detected, the room cleaned and the hospital could now be proven C. auris free, I can only sheer the staff for their alertness and following best practices. Fungi are incredibly tenacious organisms which are basically everywhere even in our bodies. I would not want to be a patient in that room for a long time, I wonder whether they will routinely re-test this (and other) room(s).
(Score: 4, Insightful) by sjames on Wednesday April 17 2019, @08:17AM (3 children)
I have to wonder given that according to TFA, there's no need to warn people who are immune compromised or who expect to be after a medical procedure that a facility has an uncontrolled infection with this fungus that has a 50% mortality rate...
(Score: 1, Interesting) by Anonymous Coward on Wednesday April 17 2019, @10:39AM (2 children)
What good telling them will do?
If they don't die, you've done the job and get their money.
If they die, telling them before will only cause them to die scared. Besides, if you scare them, they may take their money and not die in some other place.
No, no, no, no, fear is too powerful an emotion for an imunocompromised, it clouds their thinking.
Simple.
(Score: 1) by khallow on Wednesday April 17 2019, @01:03PM (1 child)
[...]
I... sense... SARCASM. I guess you answered that question after all.
(Score: 0) by Anonymous Coward on Thursday April 18 2019, @12:34AM
We're AC, everything we say is sarcastic.
(Score: 2) by darkfeline on Thursday April 18 2019, @04:17AM (1 child)
Were we reading the same article? The room was cleaned and proven free of everything EXCEPT C. auris. Kind of like a giant middle finger from the Fungi Kingdom.
Join the SDF Public Access UNIX System today!
(Score: 2) by urza9814 on Thursday April 18 2019, @03:57PM
TFS discusses two different rooms. In Imperial College London, they just sprayed a fuckton of Peroxide but the infection remained; at Mount Sinai they used specialized cleaning equipment (possibly a similar peroxide sprayer) and followed up by disposing of everything that still tested positive. Including floor and ceiling tiles. So I've gotta agree with the parent poster, that's a pretty extreme level of cleaning, and a job very well done if they managed to catch it before it spread any further.
(Score: 2) by Runaway1956 on Wednesday April 17 2019, @02:56PM (1 child)
https://www.youtube.com/watch?v=WROdwlk9_h8 [youtube.com]
Sorry, I just couldn't resist.
(Score: 0) by Anonymous Coward on Wednesday April 17 2019, @07:10PM
Did you mean "Candide"? By Voltaire? Sorry, I do not click on YouTube links without a substantial description.
(Score: 1, Informative) by Anonymous Coward on Wednesday April 17 2019, @04:29PM
https://web.archive.org/web/20190406153102/https://www.msn.com/en-us/news/world/deadly-germs-lost-cures-a-mysterious-infection-spanning-the-globe-in-a-climate-of-secrecy/ar-BBVFPi7 [archive.org]