GOOD

This Genetic Testing Tool Could Help Doctors Break The Chain During Superbug Outbreaks

Medical sleuths on the trail of drug-resistant bacteria could have a powerful new tool at their disposal.

When it comes to stopping the outbreak of a dangerous drug-resistant “superbug” bacteria, doctors often have to become detectives. They can treat each patient as they come in, but stopping the infection from spreading — that can be the key to saving even more lives.

Recently, a team at the University of Michigan and Rush University Medical Center used data from a real-world outbreak of a dangerous, drug-resistant superbug called CRKP to show that genetic testing can reveal how these superbugs are spreading, giving doctors a heads up on how to break the chain of infection and potentally stop an outbreak in its tracks.


A worker holding a petri dish full of E. coli bacteria, which are one of many different types of bacteria that may acquire antibiotic resistance. Photo by Christian Charisius/AFP/Getty Images.

The data from that CRKP outbreak provided researchers with the story of how the disease spread. In 2008, a man — who was incredibly sick and dying from a CRKP infection — was transferred to Rush University Medical Center in Chicago from a hospital in northern Indiana. Doctors there knew he wasn’t the first CRKP case in the Chicago area. Another case had cropped up just five months earlier.

Two cases of a dangerous superbug appearing in the same region had the doctors worried. A team headed by Mary Hayden, an infectious disease physician, began investigating. With a bit of legwork, they were able to find and map out the spread of the infection, watching how it hitched rides on dozens of different patients as they were transferred from hospital to hospital, nursing home to nursing home.

At the time, genetic analysis wasn’t sophisticated enough to really help Hayden track the chain of infection, but her team preserved samples from the patients anyway, hoping they could one day serve as time capsules for future investigations.

Now, they can.

The recent breakthrough involves whole genome sequencing. As bacteria grow and spread, they inevitably accumulate mutations in their genome, and by taking genetic samples from two different strains and comparing their unique mutations, scientists can tell if they’re related. It’s kind of like running a bacterial paternity test.

Hayden wanted to see if this kind of sequencing could have helped find the chain even faster during the 2008 outbreak.

To test her theory, she teamed up with Evan Snitkin’s genetics lab at the University of Michigan. Snitkin’s team tested each of Hayden’s samples in the order they were originally collected and without any prior information about each sample, essentially walking through the crisis beat-for-beat. As they did, they used the genome sequencing to build a kind of bacterial family tree.

When the two teams compared the new bacterial family tree with the results of Hayden’s 2008 investigation, they lined up nicely.

The technique won’t just duplicate conventional detective work, Hayden says. It could also help reveal nuances and insights into how a superbug is spreading, allowing doctors to move quickly to stop the chain of infection.

During the 2008 outbreak, for example, there were five patients, all at the same hospital, who had all caught CRKP. But doctors didn’t know how and when each patient picked up the bug. If one patient had carried it and spread it to all the others, for example, that’d mean the superbug was spreading within the hospital. On the other hand, if each patient had picked up the bug somewhere else and then came to the hospital, the source must be somewhere else.

Standard hygiene procedures are a cornerstone of a working hospital, but during an outbreak, further measures might need to be taken, such as isolating infected patients. Photo by Christopher Furlong/Getty Images.

Back then, the doctors had to work without knowing which scenario was true, but Hayden’s new genetic analysis showed that it had actually been a combination of both scenarios. Three of the patients contracted CRKP outside the hospital first, then two of them spread the bug to two other patients once they were hospitalized.

Had this technology been available at the time, doctors would have known as soon as they saw the test that they needed to do something to prevent transmission inside the hospital, such as isolating carriers and infected patients, as well as look for an outside source.

“The earlier we can intervene to contain an outbreak, the more likely it is that we can eradicate it," Hayden explained in a press release.

Drug-resistant bacteria like CRKP have become a major medical problem in the United States. At least 2 million Americans catch one of these infections each year and more than 20,000 die from one.

The team’s process will still need to be tested in other settings, like nursing homes and with other diseases, says Hayden, but it should work with nonbacterial infections, such as those caused by viruses and fungi, and could provide a powerful complement to standard epidemiological detective work. The team’s work appeared in the journal Science Translational Medicine.

The team isn’t the only lab that has this kind of equipment and capability, and as such, they’re hoping their results can serve as a proof of concept for doctors and public health agencies like the CDC.

When outbreaks happen, doctors have to become detectives. Thanks to tools like this, the medical Moriarty that is superbug outbreaks may soon be easier than ever to defeat.

Health
via Real Time with Bill Maher / YouTube and The Late Late Show with James Corden / YouTube

A controversial editorial on America's obesity epidemic and healthcare by comedian Bill Maher on his HBO show "Real Time" inspired a thoughtful, and funny, response by James Cordon. It also made for a great debate about healthcare that Americans are avoiding.

At the end of the September 6th episode of "Real Time, " Maher turned to the camera for his usual editorial and discussed how obesity is a huge part of the healthcare debate that no one is having.

"At Next Thursday's debate, one of the candidates has to say, 'The problem with our healthcare system is Americans eat shit and too much of it.' All the candidates will mention their health plans but no one will bring up the key factor: the citizens don't lift a finger to help," Maher said sternly.

Keep Reading Show less
Politics

There is no shortage of proposals from the, um, what's the word for it… huge, group of Democratic presidential candidates this year. But one may stand out from the pack as being not just bold but also necessary; during a CNN town hall about climate change Andrew Yang proposed a "green amendment" to the constitution.

Keep Reading Show less
test
Me Too Kit

The creator of the Me Too kit — an at home rape kit that has yet to hit the market — has come under fire as sexual assault advocates argue the kit is dangerous and misleading for women.

The kit is marketed as "the first ever at home kit for commercial use," according to the company's website. "Your experience. Your kit. Your story. Your life. Your choice. Every survivor has a story, every survivor has a voice." Customers will soon be able order one of the DIY kits in order to collect evidence "within the confines of the survivor's chosen place of safety" after an assault.

"With MeToo Kit, we are able to collect DNA samples and other tissues, which upon testing can provide the necessary time-sensitive evidence required in a court of law to identify a sexual predator's involvement with sexual assault," according to the website.

Keep Reading Show less
Health

Villagers rejoice as they receive the first vaccines ever delivered via drone in the Congo

The area's topography makes transporting medicines a treacherous task.

Photo by Henry Sempangi Senyule

When we discuss barriers to healthcare in the developed world, affordability is commonly the biggest concern. But for some in the developing world, physical distance and topography can be the difference between life and death.

Widjifake, a hard-to-reach village in northwestern Democratic Republic of Congo (DRC) with a population of 6,500, struggles with having consistent access to healthcare supplies due to the Congo River and its winding tributaries.

It can take up to three hours for vehicles carrying supplies to reach the village.

Keep Reading Show less
Health
via Keith Boykin / Twitter

Fox News and President Trump seem like they may be headed for a breakup. "Fox is a lot different than it used to be," Trump told reporters in August after one of the network's polls found him trailing for Democrats in the 2020 election.

"There's something going on at Fox, I'll tell you right now. And I'm not happy with it," he continued.

Some Fox anchors have hit back at the president over his criticisms. "Well, first of all, Mr. President, we don't work for you," Neil Cavuto said on the air. "I don't work for you. My job is to cover you, not fawn over you or rip you, just report on you."

Keep Reading Show less
Politics