Friday, February 17, 2006
Good’ Bacteria Could Save Patients from Infection by Deadlier Ones
Can it be that the stress on the use of antiseptics and antibiotics in hospitals is actually putting patients at a greater risk of suffering fatal bacterial infection?
Yes, argues Mark Spigelman, a visiting professor at the Sanford F. Kuvin Center for the Study of Infectious and Tropical Diseases at the Hebrew University of Jerusalem’s Faculty of Medicine. Prof. Spigelman points to a recent BBC report on the poor record of bacterial infections in patients (the worst in Europe) in British public hospitals, especially involving the deadly MRSA (methacillin resistant staphylococcus aureus) bacteria. Despite being around for 40 years, these bacteria are still basically found only in hospitals. The question Spigelman asks is why?
Spigelman, who is also a visiting professor at University College London, argues in an article appearing in the current online edition of the Annals of the Royal College of Surgeons of England that the stress on antibiotics and scrubbing with antiseptic soap may actually open an avenue for the more virulent forms of bacteria to attack patients. This is so because these “preventive” measures destroy beneficial bacteria, while at the same time the more “nasty” bacteria are often able to survive by adapting themselves to the pharmacological means used against them.
Since different strains of bacteria do not generally occupy the same surfaces, it would be better, argues Spigelman, to allow the harmless or “good” bacteria to live in the hospital environment, thus creating a kind of natural protection against the deadlier strains.
To test his hypothesis, Spigelman suggests experimenting with antibiotic-free hospitals in which harmless bacteria would be free to exist and there would be no environmental “incentive” for the more virulent strains to develop. Any patients needing antibiotics would be transferred to hospitals where they are in use. Doctors in the antibiotic-free hospitals would not enter and treat patients in antibiotic-using hospitals.
Along the same lines, he suggests that when doctors finish washing their hands with antiseptics, they might plunge their hands into a solutions saturated with harmless bacteria – for example “bioactive yoghurt.” The same approach, perhaps, should be applied to patients’ tissues that are to be exposed to surgery.
Admitting that his ideas may sound absurd to some, the fact is that MRSA has become widespread in hospitals – including in Israel as well as the UK -- where the most advanced antibiotics and most rigorous antiseptic measures are taken. One must ask, says Spigelman, “why more of the same does not seem to be working?” The approach he suggests is that “we ought to begin treating the cause and not the consequence of this disease.”
Hebrew University of Jerusalem
