a mysterious infection, spanning the globe in a climate of secrecy - whiteboard-ITATOUCH-img

a mysterious infection, spanning the globe in a climate of secrecy - whiteboard

by:ITATOUCH     2020-05-25
a mysterious infection, spanning the globe in a climate of secrecy  -  whiteboard
On last May, an elderly man was admitted to the Brooklyn branch of Mount Sinai hospital for abdominal surgery.
Blood tests showed he was infected with a newly discovered bacteria that is as deadly as a mysterious one.
The doctor quickly isolated him from the intensive care unit.
A fungus called auris rosary, which attacks people with weak immune systems and is spreading quietly around the world.
In the past five years, it has attacked a neonatal ward in Venezuela, sweeping a hospital in Spain, forcing a well-known British medical center to close its intensive care unit, take root in India, Pakistan and South Africa. Recently C.
Auris arrived in New York, New Jersey and Illinois, leading the federal Centers for Disease Control and Prevention to add it to the list of bacteria considered an "emergency threat. ”[
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The man in Mount Sinai died after 90 days in hospital. auris did not.
The test showed that the virus was everywhere in his room, so the hospital needed special cleaning equipment and had to tear off some ceiling and floor tiles to eradicate it.
"Everything is positive.
Walls, beds, doors, curtains, telephones, sinks, whiteboards, Poles, pumps, "said Dr.
Scott Lorraine, hospital dean.
"Mattress, bed rails, jar holes, curtains, ceiling, everything in the room is positive. ”C.
Auris is so tenacious, in part because it is not sensitive to major antimicrobial agents, which makes it a new example of one of the world's toughest health threats: the rise of drugs
Drug-resistant infection
For decades, public health experts have warned that excessive use of antibiotics is reducing the effectiveness of drugs that extend life span by treating once commonly fatal bacterial infections.
But recently, resistant fungi have also erupted, adding a new and frightening dimension to the destruction of the pillars of modern medicine.
"This is a huge problem," said Matthew Fisher, professor of fungal epidemiology at Imperial College London, who is
The author recently made a scientific review of the rise of antagonistic fungi.
"We rely on the ability to treat these patients with antibiotics.
In short, fungi, like bacteria, are evolving defense systems to survive modern drugs.
However, while world health leaders are calling for more restraint in prescribing antibiotics to counter bacteria and fungi --
The United Nations General Assembly was convened in 2016 to address emerging crises
The phenomenon of overeating continues in hospitals, clinics and agriculture.
Resistant bacteria are often referred to as "super bacteria", but it's simple because they don't usually kill everyone.
Instead, they are the most lethal to people whose immune system is immature or damaged, including newborns and the elderly, smokers, diabetes patients, and patients with autoimmune diseases who take steroids to suppress their body defense.
Unless more effective new drugs are developed and unnecessary antimicrobial use is substantially curbed, the risks will spread to healthier populations, scientists say.
A government-funded research project pointed out that without a policy to slow the rise in drug resistance, 10 million people worldwide could die from all such infections in 2050. More than 8 million people died of cancer that year.
According to official data, in the United States, 2 million people are infected with drug-resistant infections every year, and 23,000 people die from drug-resistant infections. D. C. estimate.
This figure is based on the figure of 2010;
Researchers at the University of Washington School of Medicine recently estimated the death toll at 162,000.
It is estimated that 700,000 people worldwide die from drug-resistant infections.
Antibiotics and antibiotics are essential to fight against human infections, but antibiotics are also widely used to prevent diseases in farm animals, and antibiotics are also used to prevent rot in agricultural plants.
Some scientists cite evidence that the extensive use of fungicides on crops has led to a surge in drugs --
Resistant fungi infected with humans
However, as the problem intensifies, the public knows little about it --
Part of the reason is that the presence of drug-resistant infections is often confidential.
As bacteria and fungi are similar, hospitals and local governments are reluctant to disclose the epidemic because they fear being seen as a center for infection. Even the C. D. C.
According to the agreement with the states, the location or name of the hospital involved in the outbreak is not allowed to be published.
In many cases, the State Government refuses to share information publicly, in addition to admitting that it has a case.
Bacteria have been easy to spread
Carry hands and equipment in the hospital;
Transport with meat and feces
Fertilized vegetables from the farm;
Cross-border transportation of passengers and import and export goods;
Patients are transferred from nursing homes to hospitals and hospitals. C.
The auris infected with Mount Sinai men is one of dozens of dangerous bacteria and fungi that produce resistance.
Other important fungi --
One of the most common causes of hospital blood infections
There was no significant resistance to drugs, but more than 90% of C.
Auris infection is resistant to at least one drug and 30% to two or more drugsD. C. said. Dr.
Lynn Sousa, deputy state epidemiology in Connecticut, says she sees it now.
Auris is the "number one" threat in drug-resistant infections.
"It's almost unbeatable and hard to identify," she said . ".
Nearly half of the patients
According to C. , oriis died within 90 daysD. C.
However, experts in the world did not determine where it came from at first.
"This is a creature from a Black Lagoon," said the doctor.
Tom Chiller, he is the head of the fungus department in Area C. D. C.
This is the pioneer of global detectives looking for treatment and stopping the spread.
"It came out and it's everywhere now. A deadly drug.
Resistant fungi are infecting patients in hospitals and nursing homes around the world.
The fungus appears to be present in several places at the same time, not from a single source.
The first large-scale outbreak in Europe was on 2015, when 72 cases occurred in a hospital in London.
It is reported that there are many cases of Jinshi infection in Russia. There have been at least 587 infections in the United States since 2013.
Spain, Japan, Israel, Pakistan and Pakistan have the highest number of cases in the world.
The unique pressure appeared in Pakistan back in 2008 in Delhi in 2009.
The first recorded outbreak in Central and South America occurred in 2012 at a medical center in Venezuela.
Five of the 18 infected people died.
In 2012, at least 451 patients were infected with a genetically different C. candida in southern Africa, South Africa.
Japan Candida ear (left)
2009 in a 70-year-
Old Japanese lady.
In 2015, the first large-scale outbreak in Europe, 72 cases occurred in a hospital in London.
It is reported that there have been a number of cases of Jinshi infection in Russia. Many in South Korea and the United States have had at least 587 cases of Jinshi infection since 2013.
Spain, Japan, Israel, Pakistan, Saudi Arabia, Venezuela, Africa and South America recorded the first outbreak in the Americas in 2012, at a medical center in Venezuela.
Five of the 18 infected people died.
India and Pakistan have the highest number of cases in the world.
The unique pressure appeared in Pakistan back in 2008 in Delhi in 2009.
In 2012, at least 451 patients were infected with a genetically different C. candida in southern Africa, South Africa.
Japan Candida ear (left)
2009 in a 70-year-
Old Japanese lady.
There are multiple cases of auris infection in candidaauris national Europe for the first large-scale outbreak involving 72 cases in a hospital in London from 2015.
It is reported that there have been at least 587 auris infections in the United States since 2013.
South Korea, the United States, China, Japan, India and Pakistan have the highest number of cases in the world.
The unique pressure appeared in Pakistan back in 2008 in Delhi in 2009.
The first recorded outbreak in Central and South America was in a medical center in Venezuela on 2012.
Five of the 18 infected people died.
From 2012 to 16, different auris strains on the kuwastaudiabamaliakenyasouh aa gene in South Africa infected at least 451 patients.
Japan Candida ear (left)
2009 in a 70-year-
Old Japanese lady.
South African countries have reportedly had at least 587 auris infections since 2013.
In 2015, the first large-scale outbreak in Europe involved 72 cases of a hospital in London.
The first recorded outbreak in Central and South America occurred in 2012 at a medical center in Venezuela.
Five of the 18 infected people died.
From 2012 to 16, in South Africa, at least 451 patients were infected with a genetically different Candida.
South Africa and Pakistan have the highest number of cases in the world.
The unique pressure appeared in Pakistan back in 2008 in Delhi in 2009.
A study in a hospital in Shenyang found that 15 samples were mistaken for a different fungus from 2011 to 17.
Candida auris is difficult to identify and may not be reported in other hospitals around the world.
On 2009, in a 70-year-
Old Japanese lady.
It is reported that at least 587 people in Australia have been infected with auris since 2013.
The first recorded outbreak of the Americas was in 2012, at a medical center in Venezuela.
Five of the 18 infected people died.
The first large-scale outbreak in Europe was on 2015, when 72 cases occurred in a hospital in London.
From 2012 to 16, in South Africa, at least 451 patients were infected with a genetically different Candida.
The number of cases in both countries is the highest in the world.
The unique pressure appeared in Pakistan back in 2008 in Delhi in 2009.
Russia was found in an ear under the age of 70 in 2009. year-
Old Japanese lady.
It is reported that there are many cases of auris infection in Australia, and at least 587 cases of auris infection in the United States since 2013.
In 2012, the first recorded outbreak of a medical center in Venezuela in the Americas.
The first large-scale outbreak in Europe was on 2015, when 72 cases occurred in a hospital in London.
From 2012 to 16, in South Africa, at least 451 patients were infected with a genetically different Candida.
South Africa and Pakistan are the two countries with the largest number of cases in the world.
Russia was found in an ear under the age of 70 in 2009. year-
Old Japanese lady.
New York Times Australia | Source: Centers for Disease Control and Prevention;
New infectious diseases;
Emerging microorganisms and infections
Clinical Infectious Diseases;
Journal of Infection; Mycoses;
Doughty Institute
Images from Sato and Zuo et al.
Dr. microbiology and immunization, 2015
Infectious disease expert Johanna Rhodes at Imperial College London received an emergency call from the Royal Brompton Hospital in London. C.
Auris had taken root there a few months ago and the hospital could not clean it up.
"We don't know where it comes from.
We have never heard of it.
Spread like wildfire . "
Rhodes said she was told.
She agreed to help the hospital identify the genetic features of the fungus and clean it up from the room.
Under her guidance, the staff of the hospital used a special device to spray nebulized hydrogen peroxide around a room for patients with C.
Auris, the theory is that steam washes every corner and every gap.
They let the device run for a week.
Then they put a "settlement plate" in the middle of the room with a gel at the bottom that can be used as a place for any surviving microbial growth, Dr. Rhodes said.
Only one creature came back. C. auris.
It's spreading, but it's not.
The hospital, a dedicated lung and heart center that attracts wealthy patients across the Middle East and Europe, has alerted the British government and told infected patients but has not publicly announced it.
"There is no need to issue a press release during the outbreak," hospital spokesman Oliver Wilkinson said.
This calm panic is staged in hospitals around the world.
Individual agencies, as well as national, state and local governments, are reluctant to promote outbreaks of drug-resistant infections, arguing that it makes no sense to scare patients --
Or potential. Dr.
Silke Schelenz, an expert on infectious diseases at Royal Brompton, found that in the early stages of the outbreak, governments and hospitals lacked a sense of urgency, "very, very frustrating.
"They obviously don't want to lose their reputation," said the doctor. Schelenz said.
"This does not affect the outcome of our surgery.
By the end of June 2016, a scientific paper reported "the continuous outbreak of 50 degrees Celsius ".
Auris cases of the Royal Brompton ", the hospital took extraordinary steps: closed its I. C. U.
Eleven days, the transfer of patients from the intensive care unit to the other floor was also not announced.
A few days later, the hospital finally admitted to a newspaper that something was wrong.
A headline from The Daily Telegraph warned, "after the deadly new superbug in the United States, the intensive care unit was closedK. ” (
Later studies said that although some patients were only carriers and were not infected with fungi, a total of 72 cases ended up. )
However, this issue is still little known in the world, while in Valencia, Spain, 992-
Affiliated Hospital of British university of technology.
There, 372 people were colonised, which is unknown to the public or unaffected patients
They have bacteria on them, but they are not sick.
There were 85 people infected with blood flow.
A paper in the journal mycosis reported that 41% of infected patients died within 30 days.
A hospital statement says it's not necessarily a C-section.
Orris who killed them.
"It is difficult to tell whether patients die from pathogens or pathogens because they are patients with many potential diseases and are in very serious condition," the statement said . ".
Like the Royal Brompton, hospitals in Spain have not publicly announced anything.
It still does not.
One of the authors of the article "mycosis", a doctor at the hospital, said in an email that the hospital did not want him to talk to reporters because it was "concerned about the public image of the hospital.
"This secret infuriates the patient's supporters, who say people have the right to know if there is an outbreak so they can decide whether to go to the hospital or not, especially when dealing with non-urgent matters such as elective surgery.
"Why did we read about an outbreak in about a year and a half --
Not in front of it-
The news the next day after it happened? ” said Dr.
Kevin Kavanagh is a doctor in Kentucky and chairman of the board of directors of the non-profit patient advocacy organization, American Health Watch.
"In restaurants where food poisoning breaks out, you will not tolerate this.
"Health officials say the disclosure of the epidemic has scared patients because there is nothing they can do about it, especially if the risk is unknown.
"For health care providers, it is difficult for these organisms to wrap their heads around them," the doctor said . "
Former C. Anna YafeiD. C.
Investigators who handled the outbreak of drug-resistant infections not publicly disclosed by the Kentucky hospital.
"It is really impossible to convey information to the public.
Officials in London did remind Washington, D. C. D. C.
When the Royal Brompton broke outAnd the C. D. C.
Realize that it needs to pass the word to American hospitals.
June 24, 2016, C. D. C.
A nationwide warning was issued to hospitals and medical groups and the email address candidaauris @ cdc was set up.
Check on site. Dr.
Snigdha Vallabhaneni, a major member of the fungal team, will receive a drop
"Maybe there's a message every month.
Instead, her inbox exploded in a few weeks.
In the United States, 587 people are infected with AIDS.
Auris is reported to be concentrated in 309 people in New York, 104 in New Jersey and 144 in Illinois. D. C. The symptoms —
Fever, pain and fatigue
But when a person is infected, especially someone who is already unhealthy, this common symptom can be fatal.
The earliest known case in the United States was a woman who arrived at a New York hospital in May 6, 2013 to seek treatment for respiratory failure.
She, 61, from the UAE, died a week later after a positive fungal test.
The hospital did not think much at the time, but three years later it sent the case to C. D. C.
After reading the consultation of the agency in June 2016.
In the United States, most cases occur in nursing homes in New York City, Chicago and New Jersey. Mass. N. Y. Conn. N. J. Ill. Ind. Md. Calif. Va. Okla. 200Tex. 100Fla.
25 confirmed and possible cases. N. Y. Conn. N. J. Ill. Ind. Md. Calif. Va. Okla. 200Tex. 100Fla.
Confirm andprobable, 2013-19251N. Y. N. J. Ill. Md. Ind. Calif. Va. Okla. 200Tex. 100Fla.
25 confirmed and possible cases in the New York Times | Source: Centers for Disease Control and Prevention this woman may not be the first person in the United States to be infected with AIDSauris patient.
She carries a South Asian virus that is different from the most common one here. It killed a 56-year-
The old American lady who went to India for abdominal surgery in March 2017 was infected with a caesarean section.
Orris was flown back to a hospital in Connecticut, and officials did not agree.
She was later transferred to a hospital in Texas where she died.
Bacteria have spread for a long time.
Long-term care facilities.
In Chicago, 50% of residents of some nursing homes have tested positive. D. C. has reported.
Fungi can grow on intravenous and ventilator.
Workers who provide care for patients infected with C
Orris is worried about his safety. Dr.
Matthew McCarthy has been treated several times.
Auris patient description at will Cornell Medical Center in New York, in treatment 30-year-old man.
"I found out I didn't want to touch that guy," he said . ".
"I don't want to take it from that guy and bring it to someone else.
He did his job and had a thorough examination of the patient, but he said, "there is an overwhelming feeling of being afraid to accidentally pick it up and put it on a sock, tie or robe”As the C. D. C.
Efforts to limit the spread of drugsresistant C.
Auris, whose investigators have been trying to answer this troubling question: where does it come from in the world?
The doctor met C for the first time.
In 2009, oriis was in the ears of a woman in Japan (
Latin is the ear).
It seemed harmless at the time and was the cousin of a common, easy-to-treat fungal infection.
Three years later, it appeared in an unusual test result in the Dr Lab.
Jacques Meis, a microbiology based in Nijmegen, the Netherlands, is analyzing blood flow infections in 18 patients from four hospitals in India.
Soon, the new C.
Orius seems to be in different parts of the world with the passage of a month. The C. D. C.
Investigators think C.
Auris began in Asia and spread around the world.
However, when the agency compared the entire genome of auris samples from India and Pakistan, Venezuela, South Africa and Japan, it was found that its origin was not a single place and there was no auris strain.
Genome sequencing showed that the fungus had four different versions, and because the differences were so large, they believed that these strains had been differentiated thousands of years ago, at the same time, resistant pathogens were present in four different places as harmless environmental strains.
"Somehow it seems to jump almost at the same time as it seems, it seems to spread, and it has Resistance, which is really worrying --boggling,” Dr.
Said Vallabhaneni.
There are different theories about what happened in C. auris. Dr.
Meis, a Dutch researcher, said he believed
Thanks to the extensive use of fungicides on crops, resistant fungi are developing. Dr.
When Meis heard of a case of 63-, he developed an interest in antagonistic fungiyear-
An old Dutch patient died in 2005 of a fungus called aspergagen.
It turns out to be resistant to the front
A fungal drug called isuzole.
This drug is a virtual copy of the pesticide, which is used for crop dust around the world and accounts for more than one --
Sales of fungal killing agents are third.
A 2013 paper by Plos Pathogens says that drugs-
Resistant fungi have emerged in the environment where the use of the ozonides.
For example, this fungus appears in 12% of Dutch soil samples and also in "flower beds, compost, leaves, plant seeds, tea garden soil samples, rice fields, hospital environments, aviation samples from hospitals”Dr.
Visited C. D. C.
Last summer, sharing research and theory, the same thing happened in C.
Auris was also found in the soil: Azoles created such a harsh environment that fungi were evolving and resistant strains survived.
This is similar to the concern that drug-resistant bacteria are growing due to the excessive use of antibiotics in livestock for health and growth.
As with the use of antibiotics in farm animals, the use of azol drugs is widespread in crops. "In all things
Potatoes, beans, wheat, anything you can think of, tomatoes, onions . "
Rhodes is an infectious disease expert in London.
"We push this by using a disinfectant on the crop. ”Dr.
The theory of Chiller thinks C.
Auris may benefit from the extensive use of fungicides.
His idea is C.
Auris has actually existed for thousands of years and is hidden in the cracks of the world, a bug that is not particularly aggressive.
But with the beginning of the destruction of more common fungi, C.
Auris enters the breach, a bacteria that has the ability to resist fungicides easily, and is now suitable for a world that is less resistant to fungi.
The mystery of C.
The emergence of Auris remains unresolved, and its origins do not seem to be as important at the moment as stopping transmission.
Currently, uncertainty around C.
Auris leads to an atmosphere of fear, sometimes even of denial.
Jasmine Cutler, 29, visited her last spring. year-
The old father was admitted to a hospital in New York City due to complications from surgery last month.
When she arrived at his room, she found out that he had been sitting in his own feces on the recliner for at least an hour, as no one came when he asked for help using the bathroom. Ms.
Cutler said she knew very well that the staff did not dare to touch him because a test showed he was carrying C. auris.
"I saw the doctor and the nurse look in the window of his room," she said . ".
"My father is not a guinea pig.
You don't treat him like a monster on the show.
He was finally discharged from the hospital and told him to stop carrying fungus.
But he declined to be named, saying he was concerned about a terrible infection.
Anna halero contributed to the reports of Rafael Mingde in Caracas, Venezuela and Valencia, Spain.
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