Woman Entered the National Institutes of Health

¶ … woman entered the National Institutes of Health Research Hospital in Bethesda Maryland with a serious, but fairly routine infection; however the subsequent events were to prove anything but routine. The article titled "Tracking a Hospital Outbreak of Carbapenem-Resistant Klebsiella pneumoniae with Whole-Genome Sequencing," traced the effort to discover the cause of the woman's illness, as well how the staff at one of America's most advanced hospitals dealt with the subsequent outbreak of disease. (Starr, 2012) This article interested me because it focused on an outbreak of illness, something which anyone could have been affected, but also because it discussed two aspects of the course and it's text: single-celled life forms and genetics.

The woman brought to the NIH research hospital was suffering from an infection caused by an antibiotic-resistant organism, but it was a new strain, never before encountered. About a month after she was treated and discharged, another patient came down with the same infection, and then more and more. After many unsuccessful attempts to isolate the cause of the infections, the NIH eventually used a new technology, known as "Whole Genome Sequencing," to isolate the bacteria's DNA, discover a pattern of infection, and bring it under control. This process is a new way to quickly isolate and sequence the entire genome of a particular organism, which the NIH used to help identify the pattern of infection. Of the 17 other patients who contracted the infection, six died, but it was learned that the pathogen can be transmitted in ways never before seen. (Melissa Block, Eddie Cornish)

The pathogen in question was called Klebsiella pneumoniae, which is a Gram-negative coccobacilli, relatively small, (0.5-0.8 / 1-2um), does not form spores, and is easily fixed. ("Klebsiella Pneumoniae Morphology") This particular bacterium has an optimal growth temperature range from 97-99 degrees F; which coincides with the average human body temperature of 98.6 degrees. ("Klebsiella Pneumoniae Morphology") The researchers discovered the organism can reside in the flora of hospitals, and in the general hospital environment where antibiotics are commonly used, spawning antibiotic resistance strains. The organism then can colonize in the gastrointestinal tracts of hospital patients without any sign of infection for some time, and causing them to become unintentional carriers of the pathogen.

According to the article, the best way to prevent transmission of disease was to identify the carriers of the pathogen, but in order to accomplish this task, the infection needed to be tracked. This meant the actual places, machines, people, etc., had to be tested for the presence of the pathogen, as was done at the NIH research hospital. This was facilitated by the advent of Whole Genome Sequencing, a process that can identify pathogens quickly and inexpensively through isolating and sequencing their genes. In the meantime, as the article pointed out, patients had to be isolated from other patients; gloves, gowns, and other protective clothing was mandatory for anyone having contact with an infected patient, and most importantly, any and all places, machines, etc., needed to be decontaminated with hydrogen peroxide vapor.

This article was very informative and I learned many things; primarily that there are bacteria that are resistant to antibiotics, and that this is a very serious problem in hospitals today. The technology known as "Whole Genome Sequencing" was a new technology to me, I knew that DNA could be sequenced, but the speed at which it was accomplished was astounding. It also related to our course in the manner which the disease originated, through a single-celled life form Klebsiella pneumoniae. The bacterium's morphology was intensely discussed in the article, something that was also discussed in our course and text, particularly chapters three and thirteen of Biology: Today and Tomorrow without Physiology. And the process by which the pathogen was identified, primarily Whole Genome Sequencing, involved the many of the concepts discussed within the chapters in "Unit Two: Genetics. (Starr, 2012)