Hospital infections: body piercing & attitude

When grumpy diagnostician Dr Greg House got going on hospital infections in one of the early series of the eponymous TV show, he described nosocomial pathogens as germs that have become nasty teenagers with body piercings and attitude. It’s curiously true. We have to admit at least a little responsibility for raising hospital bacteria that have acquired nasty habits like antibiotic resistance and a capacity to cause infection in the more vulnerable of our patients.

We got excited about Staph aureus when it started to do the teenage thing and step over the boundaries. Now that MRSA is common enough for us to use glycopeptide antibiotics like vancomycin on a daily basis, we have come to regret our profligate use of antibiotics in past decades. Not to be kept at the door, a crowd of Gram negative bacteria are clamouring for attention. They want to party too. Some experts predict that this will make our previous difficulties with MRSA look like a kindergarten picnic.

We haven’t quite got there yet in the local teaching hospitals. But we have made a start on breeding our own Gram negative superbug. A report that has just appeared in the Journal of Hospital Infection documents the emergence of a local Pseudomonas aeruginosa strain with little or no effective antibiotic countermeasures. It looks like infection control is about to get even more complicated. How much more complicated is illustrated in a clinical problem on Life in the Fast Lane. Although this is a community-acquired infection caused by intrinsically resistant Gram negative bacteria, it shows the impact of significantly reduced antibiotic options when making treatment choices for a patient with a severe infection.

Foreign Body Ear


  1. Hospital infections: body piercing & attitude More micrognomic magnificence!

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