An Antibiotic-Resistant Bacteria Outbreak at NIH (full documentary) | FRONTLINE

Summary

The video chronicles a devastating KPC superbug outbreak at the National Institutes of Health (NIH), highlighting the urgent threat of antibiotic-resistant bacteria in hospitals. It details how the infection, initially contained, spread within the ICU, resulting in 18 infections and 6 deaths. Despite aggressive measures and experimental treatments, KPC mutated and proved fatal for patients like Troy Stulen. His tragic death underscores the critical need for new strategies to manage antibiotic-resistant infections. The video calls for greater transparency and vigilance in preventing future hospital outbreaks, emphasizing the ongoing danger of superbugs.

Takeaways

• 😀 Antibiotic-resistant bacteria, particularly KPC, pose a serious threat in hospitals, where vulnerable patients are at high risk.
• 😀 KPC is a deadly superbug that spreads through the digestive system and can transfer its resistance to other bacteria.
• 😀 In 2011, a major KPC outbreak occurred at the Clinical Center at the National Institutes of Health (NIH) after a patient carrying KPC was transferred from a New York hospital.
• 😀 Despite rigorous infection control measures, the outbreak spread to multiple patients in the intensive care unit (ICU) and later to the general hospital population.
• 😀 KPC infections are difficult to treat, with conventional antibiotics being ineffective and experimental treatments also failing.
• 😀 Silent carriers, individuals who carry the bacteria without showing symptoms, were found to be spreading KPC throughout the hospital.
• 😀 Hospital-wide testing and isolation of infected patients helped contain the outbreak, which lasted six months and resulted in 18 infections and six deaths.
• 😀 Troy Stulen, a patient recovering from a bone marrow transplant, became infected with KPC eight months after the outbreak had seemingly ended.
• 😀 Despite treatment with the antibiotic colistin, Troy's infection mutated, rendering the treatment ineffective, and he passed away after his vital signs failed.
• 😀 The KPC outbreak underscored the need for hospitals to remain vigilant about the risks of antibiotic-resistant bacteria and to develop new strategies for managing such infections.
• 😀 The NIH researchers emphasized the importance of sharing lessons learned from outbreaks like this to prevent future occurrences in other hospitals.

Q & A

What is KPC and why is it dangerous?

KPC (Klebsiella pneumoniae carbapenemase) is a type of superbug bacteria that is resistant to many antibiotics, making it very difficult to treat. It can cause serious infections, particularly in vulnerable patients such as those in hospitals, and has a high mortality rate.

How did the KPC outbreak begin at the National Institutes of Health (NIH)?

The KPC outbreak at NIH started when a patient with a rare lung disease, who was carrying KPC, was transferred from a New York City hospital to NIH in Bethesda, Maryland, in the summer of 2011. This was the first time KPC had been identified at NIH.

What steps did the NIH take to contain the KPC outbreak initially?

NIH implemented a high level of alert, placed the first patient in enhanced contact isolation, and took extra precautions such as requiring all hospital staff and visitors to wear gloves and gowns when entering the patient’s room. Despite these measures, the bacteria continued to spread.

What made the KPC outbreak at NIH particularly challenging to control?

The KPC outbreak was challenging to control because the bacteria spread through silent carriers—people carrying the bacteria without showing symptoms. The bacteria also spread beyond the intensive care unit (ICU) into the general hospital population, making containment difficult.

What role did genetic researchers play in the investigation of the outbreak?

Genetic researchers played a crucial role by analyzing the DNA of the KPC samples. They discovered that silent carriers were likely spreading the bacteria throughout the hospital, which was a key breakthrough in understanding how the outbreak was happening.

What happened when the hospital’s aggressive containment measures seemed to work, only for KPC to resurface later?

Even though the outbreak seemed under control after six months, KPC resurfaced unexpectedly when it was discovered that Troy Stulen, a patient who had been treated at NIH, tested positive for KPC eight months after the outbreak was initially thought to be over.

How did Troy Stulen become infected with KPC despite the hospital’s previous efforts to contain the outbreak?

It is unclear exactly how Troy became infected with KPC, but doctors believe it may have been introduced by a patient from the earlier outbreak who returned for a routine follow-up. This highlights the persistence and unpredictability of the bacteria.

What were the treatment options for KPC, and why were they ineffective?

Several antibiotics, including combinations of five or six antibiotics, were tested to treat KPC infections. An experimental antibiotic was also used, but none were effective in treating the bacteria. This highlights the difficulty of dealing with antibiotic-resistant superbugs.

What was the impact of the KPC outbreak on patient mortality at NIH?

During the outbreak, 18 patients were infected with KPC, and six of them died from complications related to the infection. The high mortality rate underscores the serious threat posed by antibiotic-resistant bacteria in hospital settings.

What lessons did the researchers at NIH learn from the KPC outbreak?

The researchers at NIH concluded that KPC and similar antibiotic-resistant bacteria are persistent threats that will continue to evolve. They emphasized the need for ongoing vigilance, the development of new treatment strategies, and a cultural shift in how hospitals handle such infections.