Recently, a Spanish hospital case suggests that antibiotic-resistant bacteria may sometimes migrate from the bowels and into the lungs.
Although bacteria can travel through the body via routes we don’t know about, it is not uncommon to see a case where infection spreads clearly.
Spain is an example of a rare exception. After a seizure, the patient was taken to Badalona’s intensive care unit. They were kept mechanically ventilated for 39 days while doctors administered antibiotics to treat a lower-airway infection.
The patient’s lungs showed evidence of a bacteria on day one. Pseudomonas aeruginosa – Common infections in the lungs, bladder, and gut – It was believed that the patient had inadvertently done so. You breathed in saliva, food, and vomitPerhaps during or after their seizure.
The patient became ill with a urinary tract problem on day 12. Doctors prescribed a different antibiotic. meropenem. Shortly thereafter, the treatment was ended. P. aeruginosa The first time it was discovered in the patient’s stomach.
This particular population was now immune to meropenem. But it wasn’t done yet. The patient was at high risk for death when the resistant lineage in their gut returned to their lungs. pneumonia.
Fortunately, the patient’s immune systems kicked into action and they were discharged after spending more than a month in hospital. However, it could have been much worse.
Culture screening of blood samples did not show any evidence of infection during the patient’s stay. P. aeruginosaThere is no evidence of infection. Anal swabs and breath samples were the only ones that detected the bacteria. This meant that doctors might not have been able to determine how sick their patient really was if they weren’t vigilant.
Researchers found evidence that the infection probably began in the stomach three weeks prior to the ICU visit by studying the genetic diversity and bacteria collected from patients during their stay in the ICU.
The infection began to develop on day 24 of ICU stay and was now established in the patient’s lungs.
The authors discovered an antibiotic-resistant lineage in the gut and lungs. Say it provides “strong evidence of gut to lung transmission” – and possibly back again.
The authors stated that “the presence of this type in the stomach and lung suggests that either meropenem immunity evolved in the gut before transmission the the lung or that this lineage is secondarily transmitted to the gut from the lung after developing meropenem resist in the lung.” Write.
It is important not to draw general conclusions from a single case, but Spain’s patient provides an opportunity to monitor how infection may evolve and spread in real-time.
A gut infection that is capable of spreading to the lungs and carrying antibiotic resistance could be a serious infection doctor should consider.
Studies Have been shownGut colonization is often preceded by lung infections. The same strains are frequently found in both. These two lines of evidence indicate that the bowels can act as a reservoir to transmit bacterial infections like Pseudomonas.
The authors stated that “in this instance, resistance was driven in part by the spread independent lineages within the gut and lung that were adapted locally to differences in antibiotic concentration.” Write.
Previous Research Also It is possible to suggestThe movement of bacteria populations can accelerate antibiotic resistance by allowing them to move around.
Spain’s patient, for example, displayed empathy. P. aeruginosaFollowing meropenem treatment, there was a noticeable change in the bacteria’s gut. The authors speculate that antibiotic treatment may have facilitated this gut to lung transmission by eliminating competing bacteria that is usually kept. PseudomonasCheck, for instance.
“Our study suggests that preventing the colonization of the gut or transmission from the gut to the lung may be a viable strategy for preventing this problem.” Pseudomonas“Infection in critically ill patients,” said the authors Final conclusion.
The study was published in Nature Communications.
