Resistant Bacterium Surfaces in Alabama

A few posts ago I wrote about the emergence at Methodist Hospital in Houston TX of the truly antibiotic treatment-resistant Klebsiella bacterial strain. The infectious disease and internal medicine clinician researchers had been following the presence and prevalence in patients in the ER and hospital wards since 2011 through 2015. They had recently published their results in the prestigious journal Nature.

Methodist Hospital had been tracking this dangerous bug since it was noticed in patients in that hospital in 2011 or slightly before. The Methodist Hospital clinical researchers had tracked large numbers of patients both at risk and not at risk for harboring “bad” germs such as the better known MRSA [methcillin resistant Staph Aureus bug] as all hospitals have done for over a decade or more as standard procedure upon any admission to a hospital. They were taken aback and I dare say, medically frightened by their findings that larger than expected numbers of patients had this resistant Klebsiella.

Well, now it turns out that an equally antibiotic-resistant bug, a variant of our old Gram-negative E. Coli bug has turned up in Alabama centers in an alarming incidence that cannot be ignored either. This I fear really fear is the start of what all of us in public health, medical epidemiology, infectious disease and internal medicine have anticipated for years, the start of the antibiotic resistant age with multiple bacteria being antibiotic resistant.

For several years, the strategy in treating moderately resistant bacteria has been to employ typically dual or triple antibiotics to treat infections and this has until recently been quite successful. But the thinkers and ponderers in medicine, even in psychiatry such as those who practice in large hospitals and see patients in growing numbers with medical conditions that predispose to resistant ‘bugs,’ such as modern immunocompromised patients engendered by our novel non-chemotherapeutic anti-cancer drug regimens that do not utilize ‘cell poisons’ as in the beginning days of oncology and HIV patients who are immunocompromised out of hand because of the way the HIV virus operates and its routine effects on suppressing the immune systems of the body. I myself am partially immunocompromised by the treatment I do daily for multiple myeloma and have had a few episodes of serious body-wide infections or sepsis and face with some degree of trepidation this new issue of antibiotic resistant bacteria. But a number of other populations fall into these vulnerable categories, such as infants, children, the elderly, persons on the new drugs for rheumatoid arthritis and psoriasis. These are not small elements of our populations worldwide by any means.

So without really any or too many new wonder antibiotics on the horizon to save us all, the researchers are scramblers as fast as possible in another direction that likely is better. The development of vaccines bears promise and bacteria do not change and morph and trades parts of DNA in their annual changes such as in the various flu strains and so present hopefully, slower moving targets for vaccines. It appears we will enter into a new era of vaccine research and development since the days of the polio vaccines and childhood disease vaccines.

I also would throw down the gauntlet to the anti-vaccine movement parties in this country, for whom I have a great deal of antipathy for generating in my view truly ‘fake news and information’ about the supposed harm of vaccines and causing such alarm among the relatively less educated and even well-educated parents of the last 20 years or so  to let their children go unvaccinated. Because of this, we are having more and more outbreaks among the much larger cohorts of the unvaccinated of measles, mumps, whooping cough and even diphtheria as the collective “herd Immunity” is diluted by the larger numbers of unvaccinated children at the mercy of their misinformed parents. And yes as a physician I am well aware of the tragedies caused by the RARE cases of PANDA syndrome, catastrophic CNS cases of brain damage due to encephalitis which things like measles cause in large numbers in severe cases in the unvaccinated in addition to deafness and other tragic consequences. One could hope that the anti-vaccine ill-informed and just plain dead wrong movement in this country and others would wake up when the realities of the antibiotic resistant bacteria start causing widespread deaths and the only defense against them on the horizon or on the pharmacy shelves is bacterium-specific vaccines. Then when they, their elders, and their children are threatened in very real stark life and death terms, I would hope to God that they come to their rational modern day senses.