NIH Takes Extraordinary Steps In Fighting 'Superbug'

When an outbreak of a highly drug-resistant infection occurred at the National Institutes of Health's research hospital, doctors took extraordinary measures to try to stamp it out. Among them was quickly deciphering the entire genetic code of the bug to try to trace how the germ spread. Audie Cornish talks to Rob Stein.

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MELISSA BLOCK, HOST:

From NPR news, this is ALL THINGS CONSIDERED. I'm Melissa Block.

AUDIE CORNISH, HOST:

And I'm Audie Cornish.

We turn now to a story about the extraordinary steps one hospital took to fight a deadly outbreak of what doctors call a superbug. It was a bacterial infection that was highly resistant to antibiotics. This week, the National Institutes of Health revealed details about the outbreak in a scientific paper.

NPR's Rob Stein is here to tell us what happened. Welcome, Rob.

ROB STEIN, BYLINE: Hi, Audie.

CORNISH: So this outbreak occurred at a place you would think would be able to handle it, the National Institutes of Health Research Hospital outside Washington. So, how exactly did this get started?

STEIN: Right, the outbreak started in June of last year. A very sick woman was rushed to what the NIH calls the Clinical Center. It's in Bethesda, Maryland. And it turned out she was carrying a bacterium called KPC, for short. It's a fairly common bacteria and usually is harmless. But in this case, it was a fairly new strain that's highly resistant to antibiotics, which means it posed a big threat to all the other patients in the clinic.

CORNISH: Now, antibiotic resistant infections are a huge problem for hospitals everywhere. But I take it what's different here is how aggressively the NIH reacted to it.

STEIN: Yeah, antibiotic resistant infections is a huge problem, as you just said. In fact, something like 99,000 people die every year in this country from these infections. And so, the NIH knew they had to take really aggressive steps to try to keep it from spreading to the other patients. And so, they did all the things that you normally do.

They made sure that anybody going near this patient protected themselves. They made sure that the patient herself didn't walk around near anybody else, and anybody treating her stayed away from other people. They sterilized all the equipment that came near her.

CORNISH: But it still spread.

STEIN: That's right. Despite all these efforts, it ended up spreading to other patients who were already at the clinical center. In fact, about a month after she was discharged one of the patients there turned out to be infected. And then one patient pretty much every week for the following weeks, one by one, started to show up with the same infection. So they really pulled out all the stops to try to figure out what was going up here.

They ended up tearing apart some plumbing. They even had a robot come in to spray hydrogen peroxide to sterilize the empty rooms after patients had left. And one of the most interesting things they did is they used this new technology known as Whole Genome Sequencing, which enables you to decipher the entire the entire genetic code of an organism very fast and very inexpensively. And in this case, they used this technique to decode the DNA of this KPC bacterium to trace the pattern of the spread and try to figure out what was going on.

CORNISH: Now, they were able to bring it under control. What happened in the end?

STEIN: Yes, eventually it ended up spreading to a total of 17 other patients, six of whom died. But because they did the sequencing, they figured out that this original woman who came in infected ended up spreading it from two different parts of her body, three different times. And it was spread in ways they had never anticipated; in certain equipment, in certain interactions between the staff and this patient. And by doing that they were able to finally get the outbreak under control completely.

CORNISH: So are there any lessons to be learned from this experience?

STEIN: Yeah. Well, it really shows how hard it is to fight one of these outbreaks, even at a place like the NIH, which you'd think would be, you know, uniquely equipped to deal with it. And it also shows that this new technology, this genome sequencing, could be really useful for other hospitals when they face similar threats.

CORNISH: Rob, thank you.

STEIN: Oh, thanks for having me.

CORNISH: NPR's health correspondent Rob Stein, he was talking about a new paper on how the NIH tried to control an antibiotic-resistant bacteria. The paper is published in the journal Science Translational Medicine.

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