Before this weeks post I would like to make an announcement. At this stage I am claiming victory in the debate. You can check out the results on the poll itself here. First I would like to thank myself for putting up such an amazing argument. I would also like to thank Thomas for putting up an insufficient fight, I’ll save some cake for you buddy. I would like to thank my wife and our dogs whose love and support get me throu………..<music plays me off stage>.
I don’t want to sound like I’m brave or a hero or anything but each and every day I, alongside my lab-mates aka ‘the league of extraordinary scientists’, stare down pathogens like S. pneumoniae, E. coli, S. flexneri and L. monocytogenes. We go into battle to try and work out how it is that we can tackle these bad guys on a global scale, developing vaccines and anti-microbials or simply understanding their weaknesses better.
So how do we protect ourselves from these harbingers of death in the lab? A gown, gloves and glasses when appropriate and ethanol on everything all the time to ensure it’s sterilised regularly. Really doesn’t seem like much of a barrier when I think about it.
In some cases we specifically work on weakened strains to help protect ourselves further but we do rely heavily on our ability to handle these bacteria carefully and with common sense. However, despite all the precautions we take in the lab I’m reasonably sure some of us would be carrying the bugs we work on.
Even though I’m unlikely to get sick playing with my pneumo strains it has been playing on my mind ever since I heard Prof. Patrice Nordmann speak at that conference I keep name dropping. Prof. Nordmann was an excellent speaker who gave a presentation regarding the rise in antibiotic resistance levels in French hospitals (not because they are particularly notable, just because he works in France). During his talk though he mentioned a paper he had written and had published in the New England Medical Journal regarding a lab induced injury.
The researcher/patient developed acute paronychia (inflammation of the skin around the fingernails) after handling a strain of Staphylococcus aureus that produced a nasty toxin called Panton–Valentine leukocidin. These strains have started to become more and more prevalent recently and are normally associated with nasal infections and subsequent swabbing of the nasal passages of the patient showed the presence of the same strain.
Its wasn’t a Mickey Mouse infection either, this patient had 2 rounds of surgical drainage, 3 weeks of daily finger baths in antiseptic agents, a one month course of antibiotics, 3 times a day nasal decontamination for a week and twice a day full body showers in 4% chlorhexidine gluconate.
Unfortunately this isn’t an isolated incident. Accidents happen and when you work on infectious disease those accidents can be a big deal.
Another highly publicised case was that of a researcher in Germany who gave herself Ebola. Whilst the Staph patient probably just spilt some on his hand and was unlucky this woman gave herself a needlestick injury whilst inoculating mice with the deadly virus. It took a team of experts and an experimental vaccine that had never previously been tested on humans to save her life.
We can even look closer to home (well, my home at least) where we had the ‘lab bungle’ involving Q fever at the SA Pathology in Adelaide. Q fever is caused by Coxiella burnetii, a bacterium found naturally in the soil in both vegetative and spore forms. Most human cases of disease are associated with animal handling. Apparently some protocols may have been breached resulting of the release of the bacterium resulting in a handful of researchers testing positive and at least one requiring hospitalisation.
Finally there is the case of the Edinburgh Outbreak. During the 1960-1070’s in Scottish hospitals increased rates of Hepatitis B infection were observed in staff and home contacts of patients. Over a 13 year period 15 staff or home contacts developed viral hepatitis including 4 cases that were ultimately fatal including a surgeon, a receptionist, a technician and a house officer. The outbreak had many sources caused largely by breaks in protocol but the spread of the infection was possible as of the 15 staff or home contacts that became patients; 5 had blood on glass or needle-stick injuries, 2 were exposed during a surgery and resuscitation procedure on a HepB patient in some unidentifiable way, 2 were directly contaminated with patient blood, 3 handled contaminated material and 3 patients, despite having no accident or direct contamination developed viral hepatitis this included a technician who cleaned the dialysis machines and the specimen receptionist in haematology.
While we joke around on the blog a bit about bacteria and diseases it’s sobering to think that in labs and clinics around the world people doing everything they can to research, identify and understand the things that make us sick and are brave enough to work with these very organisms that, given the opportunity, will make them very sick as well.
Marmion BP, Burrell CJ, Tonkin RW, & Dickson J (1982). Dialysis-associated hepatitis in Edinburgh; 1969-1978. Reviews of infectious diseases, 4 (3), 619-37 PMID: 6812192
Burrell CJ, Tonkin RW, Proudfoot E, Leadbetter G, Cowan P, Lockerbie L, Gore S, Lutz W, & Marmion BP (1977). Prevalence of antibody to hepatitits B surface antigen among staff in an Edinburgh hospital. The Journal of hygiene, 78 (1), 57-68 PMID: 264499
Nordmann, P., & Naas, T. (2005). Transmission of Methicillin-Resistant to a Microbiologist New England Journal of Medicine, 352 (14), 1489-1490 DOI: 10.1056/NEJM200504073521418