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We have an epidemic that has not yet occurred in any European country. A bacterium resistant to all antibiotics is spreading in Polish hospitals. In addition, he can pass his skill on to other microorganisms. Dr. Tomasz Ozorowski, an outstanding microbiologist, spoke in an interview for MedTvoiLokony a year ago about the epidemic. Unfortunately, the Ministry of Health disregarded the problem. The situation got out of hand.
- The epidemic, unprecedented in Europe, is spreading in Poland, because medical personnel wash their hands too rarely
- Klebsielle pneumoniae New Delhi is resistant to all drugs available
- The former minister of health did not implement effective measures to curb the spread of the epidemic in a timely manner
It all started five years ago at the end of 2012 with a missionary, who came from Tanzania, who was treated in a Poznań hospital. Klebsielle pneumoniae New Delhi was diagnosed in him. The world had known this type of bacteria four years earlier. It was first diagnosed in a patient in the Indian capital. It turned out that it has the ability to produce enzymes that break down all antibiotics, including the so-called last chance. It spreads mainly in hospitals where the proper sanitary regime is not respected. In Poland, we already have an epidemic in the Mazowieckie and Podlaskie voivodships. There is a risk that it will occur in other regions of Poland. Interestingly, genetic studies show that the source of all infections is the same bacterium diagnosed in the first patient in Poznań.
Incalculable stick
The bacterium Klebsiella pneumoniae New Dehli, which is actually a variety of pneumonia, is perfectly adapted to life in the human digestive system. It also lives on human skin. When it stays in the digestive system, we become only its carriers and we can be a source of infections for others. Contrary to its name, it does not just attack the lungs. Dangerous infections occur when New Delhi gets into the urinary, respiratory systems, and especially into the blood of the patient. People who develop the so-called the gate of infections, i.e. he puts a catheter into the urinary bladder, performs an operation, treats with a respirator. In them, it can cause blood poisoning, pneumonia, bladder inflammation and fatal sepsis. – There are three possible scenarios: either the body defeats the pathogen by itself, or the infection becomes chronic, or the patient dies. In case of blood poisoning, even every second patient dies. It should be noted, however, that the bacterium does not have a greater potential than other bacteria to attack our body and in most patients it will only cause a carrier state in the gastrointestinal tract without symptoms of infection – says microbiologist Dr. Tomasz Ozorowski.
Klebsiella pneumoniae New Dehli is the smartest bacterium in the world, because it can easily spread in hospitals and produce enzymes that destroy all antibiotics that are harmful to it. In addition, this ability is shared with other bacteria belonging to completely different strains. It can “teach” resistance to drugs, the Escherichia coli bacteria that live in the intestines of every human being, which, by getting into other organs, can also cause serious infections that can even lead to death.
In Poland as in Asia
No other European country has recorded such a number of New Dehli infected with Klebsiella pneumoniae as in Poland. The highest frequency is that of India and Pakistan. In these countries, carriage in the entire population is common and may, according to some estimates, be up to 20%. inhabitants of the country. In Poland, the problem of the epidemic spread of New Delhi bacteria concerns the Mazowieckie and Podlaskie voivodships. Meanwhile, experts say that after crossing a certain threshold, there is a snowball effect, very difficult, and actually impossible to stop. In Poland, the bacterium has already left hospitals and is diagnosed in people who have not been treated in these facilities. So they got infected from others, although the risk is relatively small. – We have 5 detected and documented infections. Their actual number may be several times higher, informs Dr. Ozorowski. In Great Britain, where there are many Indians and Pakistanis who visit their homeland, there are about 500 patients a year, most of whom have different bacterial strains. In England, patients diagnosed with this type of microorganism are immediately subjected to isolation and there is no such mass transmission as in Poland.
Minister without imagination
Despite alarms and appeals from specialists, in March last year the then Minister of Health Konstanty Radziwiłł assured that his ministry was monitoring the situation. – The number of cases is increasing. But don’t worry, it’s not an avalanche – he said. He misjudged the situation because he either lacked imagination or believed that Klebsiella pneumoniae New Dehli would obey the minister’s wishes. Meanwhile, the data spoke for itself. The National Reference Center for Antimicrobial Susceptibility (KORLD) reported in 2013 that 105 infected and carriers were diagnosed nationwide. Since then, their number has increased 50 times. – There are so many of them that we cannot keep up with the tests confirming the infection – says Dr. Ozorowski.
It is the worst in Mazowieckie and Podlaskie. According to the KORLD report, 2015 cases were found in Mazovia in 410. A year later, there were already 1400 of them. But then the Masovian Sanepid wrote on its website that despite the increase in registered cases, the current state did not justify the media creating panic about the epidemic.
From November 2015, hospitals in Mazovia were obliged to screen patients on admission, observe the rules of isolation of infected, hygienic procedures, especially hand hygiene and surface disinfection, and to increase the intensity of internal controls, as well as to report epidemiological data. Probably the money, isolation rooms and staff did not strictly follow these recommendations. Only about 40 percent. appropriate isolation units for patients were used. The current data of the Department of Health Services for the third quarters of 2017 prove the continuing disturbing epidemiological situation. During this time, more than 1700 cases were detected.
As sterile as in a hospital
A hospital is a particularly good place for bacteria, because there are many convenient ways to reach the human body. Patients after surgery have wounds that are perfect for this. In addition, they are subjected to catheterization, puncture, intubation, and this allows microbes to travel deep into the human body. And since the patients are treated in the hospital and their immunity is damaged, they are not able to cope with these dangerous intruders. Specialists emphasize that nosocomial infections cannot be avoided, but can be reduced by up to 70 percent. According to the microbiologist Dr. Tomasz Ozorowski, Poland lacks an optimal system to prevent nosocomial infections. Our regulations force institutions primarily to perform mock bureaucratic activities. Papers are filled in piles, but most often there is no analysis of the effectiveness of preventive measures. Nobody even counts them exactly, because they lack tools, knowledge, and it does not pay off for anyone, because it could expose the hospital to compensation claims. Ozorowski adds that one of the greatest sins of Polish hospitals is inadequate hand hygiene of medical personnel. Studies on the use of hand disinfectants in our clinics clearly show that doctors and nurses wash their hands too rarely. And they should always do this between examining each patient. – Disposable gloves are overused. However, without washing your hands, just taking them out of the containers spreads the bacteria – warns the microbiologist. In addition, our white staff do not change their work clothes every day. Meanwhile, the recommendations say that such garments must have short sleeves and be washed frequently. Klebsiella pneumoniae can live outside the human body for weeks, including wearing an apron. The bacterium is also spread through items that doctors and nurses carry with them – pens, cell phones, etc. So if the new minister does not take the problem seriously and implements a corrective program quickly, the post-antibiotic era in which these drugs become useless will become fact. Patients should also take care of their own safety and make sure that hospital staff have always washed their hands before handling them.