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JohnnyV

Still Lisa: Strep infection

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What a story. Thank you for sharing it.

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Thanks for posting that for me, Johnny. I know of another woman, from salt lake city also, who lost both her legs and most of her fingers in the same way, also last year...what is up in Utah lately? If you're gonna have a baby here, be sure to cross over into nevada or colorado first.... :rolleyes:

Judy

Utah

LBK

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Streptococcus pyogenes, even the toxigenic variants, has been with us for a long, long time. The number and variety of diseases caused by different variants of this same organism is in the dozens. Some of the earliest bacteriology done was dealing with the disease called "childbed fever," an horrific form of strep infection often transmitted by doctors and midwives who failed to wash their hands between patients. Even in the age of antibiotics it has remained a problem because killing the bacteria themselves doesn't kill the incredibly potent toxins they've already released--the toxins go on to destroy tissues or cause intravascular coagulation, cutting off circulation. While antibiotic resistance is part of the emerging picture of this syndrome another, perhaps greater, factor is the increasing number of victims who survive the infection. In the past, the syndrome was so devastating and so fast that patients would die before any diagnosis or treatment strategy could be devised. The laboratory often couldn't even detect the microbe causing the problem--the patient died before sufficient numbers of the bacteria appeared to detect.

Is it just a problem in Utah? No,certainly not. Most hospitals (good ones at least) are re-examining their infection control procedures to try to prevent these cases from occurring. Some measures are easy--handwashing and good aseptic technique for example. But sometimes the solutions are not obvious, and are very difficult to implement.

(I don't work directly with this bacterium any more but I've taught medical microbiology for many years. I can try to help with any questions you might have about it , though there may be others on the board better qualified than me. Actually, since I lost my leg to a bacterial infection I was too stupid to recognize there may be a lot of folks on the board better qualified than me!)

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Thanks for the original post Johnny.

Trwinship, I'm glad you posted that follow up as there sometimes seems to be a lot of hysteria about hospital infections as though they're something new and sinsiter. I noticed in the article that around 1 in 3 children carry the bacterium as opposed to 1 in 20 adults. When I was young children weren't allowed to visit mothers in the maternity ward unlike now where it's considered cruel not to let the other kids see mum and the new baby. I also noted that the infection can be picked up through bruises or insect bites so it's entirely possible to get this before having surgery and then to have it erupt post surgery when you are at your weakest.

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Appreciate the posting Johnny, it surely does remind one to be thankful for their blessings.

Sheila lbk

Maine USA

Keep Smiling :)

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I'm glad you posted that follow up as there sometimes seems to be a lot of hysteria about hospital infections as though they're something new and sinsiter. I noticed in the article that around 1 in 3 children carry the bacterium as opposed to 1 in 20 adults. When I was young children weren't allowed to visit mothers in the maternity ward unlike now where it's considered cruel not to let the other kids see mum and the new baby. I also noted that the infection can be picked up through bruises or insect bites so it's entirely possible to get this before having surgery and then to have it erupt post surgery when you are at your weakest.

Just like my son, Muz. He contracted an hospital acquired MRSA infection (lab reports confirmed this), after his C-section delivery. Thankfully, he's OK now.

Having worked in the health sector for many years, I would say that a large proportion of these infections are caused by one or a combination of the following: Poor hygiene (staff, environment, visitor & patient), poor clinical technique, high patient turnover and lack of funding.

Lizzie :)

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Marcus, my understanding of the "strep belt" phenomenon is that both states were host (if that's the right word) to outbreaks of rheumatic fever in infants all caused by the same strep genotype, even though the outbreaks were separated by as much as 13 years. Rheumatic fever is yet another form of Strep pyogenes infection which can affect the valves of the heart. The forms of Strep which do this are not the same as those responsible for the toxic shock syndrome described in Johnny's article. The mystery may be why so few Strep isolates make the really potent toxins--although any factor a bacterium makes that really kills off the host quickly is not a good thing from an evolutionary sense--killing off a host the bacterium depends on kills the bacterium, too.

Lizzie, you are right about the factors you mention being extremely important in spreading these infections, and the absolute need for exemplary infection control practices. However, another factor we just don't understand is host susceptibility. As mentioned in the article, only some people appear to be susceptible to the full potency of toxic shock factors. I remember the case we had a few years ago of a nurse (not to single out health care people--this could as easily have been a patient or anybody off the street) whose respiratory tract was colonized by a particularly nasty toxigenic strain of strep. She worked in the ICU and was herself perfectly healthy. Some of her patients also became colonized with genetically identical strep--apparently from her although her technique was flawless---and were also perfectly healthy. While it sounds like a dangerous situation it had a happy ending, in that none of her patients ever developed toxic shock syndrome, and with antibiotic therapy the nurse was able to shake the bacterium and return to the ICU.

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