Doctors Struggle to Treat Gram-negative Bacterial Infections

This article begins with the story of Richard Armbruster, who went to the St. Louis hospital for a hip replacement and ended up dying two months later from an infection. The bacteria that killed him is one of many that are becoming more lethal to hospital patients. This group of bacteria, called Gram-negative bacteria, are receiving little attention from pharmaceutical companies because they do not appear as deadly as other infectious organisms like MRSA. Hence, there is little research going into the development of cures for Gram-negative bacteria, which is especially frightening considering that these germs are evolving and becoming more resistant to existing medications.

Research on Gram-negative bacteria is particularly distressing. The SUNY Downstate Medical Center has found that more than twenty percent of infections in Brooklyn hospitals that are caused by a particular strain of Gram-negative bacteria are essentially resistant to all antibiotics. Although there are few American statistics on the effects of Gram-negative bacteria, European hospitals have conducted surveys on the subject. They have found that two-thirds of 25,000 deaths caused by “some of the most troublesome hospital-acquired infections.”

MRSA is still a threat, of course. It continues to be the primary source of hospital infections, and, unlike Gram-negative bacteria, can infect people outside of hospitals. In comparison, gram-negative bacteria usually only infects hospital patients with weakened immune systems, though it can survive long periods of time on surfaces and “enter the body through wounds, catheters, and ventilators.” The main problem lies in Gram-negative bacteria’s resistance to antibiotics.

Resistant strains of these bacteria must be treated with colistin and polymyxin B, which are now rarely used because they can cause kidney and nerve damage. Their infrequent use has prevented the bacteria from evolving much resistance to them yet. Unfortunately, if the infection is life-threatening, doctors must treat the patient and take the risk of causing other damage to their organs. Additionally, in some cases, the bacteria prove to be resistant to even these medications.

The severity Gram-negative bacteria infections has even caused some patient advocacy group to express that hospitals need to take better preventative measures against infection and not overuse antibiotics. One such example is the Safe Care Campaign, started by a couple whose son died of a Gram-negative infection.

I chose this article because I found it to be very disturbing. I find myself frightened by the fact that people in hospitals are dying from infections that are proving to be increasingly resistant to antibiotics. These bacteria are simply not receiving the attention they deserve. When doctors sometimes have to resort to antibiotics that may permanently damage the patient’s kidneys in order to fight a life-threatening infection, something is wrong. Additionally, there are very few facts or figures on the effects of these bacteria, and the few that exist show very distressing results. Overall, I think that this article demonstrates a huge deficiency in bioengineering.

http://www.nytimes.com/2010/02/27/business/27germ.html?adxnnl=1&ref=health&adxnnlx=1267326152-N7DdMbEEWXgJaXwaWMZK8A

Nicole Wanlass, VTPP 435-502