Pseudomonas aeruginosa kills 20 year old Brazilian model

[liveonearth]

Her name was Mariana Bridi, and she was from a poor family. She started modelling at age 14.
She was competing in a beauty competition in China. On Dec 30 she went to the hospital, was misdiagnosed with a kidney stone, given medicine and sent away. Two days later she was back and much sicker. They diagnosed her with a UTI, and then septicemia (bacteria in the blood). In an effort to save her life they surgically removed her kidneys, feet and hands, and part of her stomach. Her stomach was bleeding, and they didn't know why. It appears that they had trouble finding blood for her, saying that her type (O negative) was "rare". Huh?

Certainly, if she had not been misdiagnosed, and if she had better care when she first presented, she might be whole and alive today. This case, as with many, appears to be one that would have been much better treated using naturopathic principles. I suspect that her initial immune response to the infection was suppressed (I bet she took meds to keep the fever down) and refraining from suppression and supporting her vital force might have led her to victory. But it is too late now.

P. aeruginosa is a gram negative rod, strict aerobe, and can grow in distilled water with few nutrients. It's ubiquitous in soil, water, plants, food, and hospitals. It is resistant to many antibiotics. Now known as one of the most lethal nosocomial infections, it is well known to infect burn patients (remember, strict aerobe so it likes the surface). It produces two pigments, pyocyanin (blue pus) and pyoverdine (flourescent under UV light and used to monitor burn pts for infx). It also causes recurring pneumonia in cystic fibrosis patients.

Virulence factos include indotoxin, exotoxin A, exoenzyme S, adhesions, and an antiphagocytic capsule. Exotoxin A is an A-B toxin with the same mechanism of protein synthesis inhibition and cell death as diptheria toxin. Exoenzyme S is an ADP-ribosylating toxin that targets several ceullular proteins.

It is rare for P. aeruginosa to infect urinary bladders--usually only when there is an indwelling catheter...but the bug is an opportunist, and will infect anywhere that is weakened. I have my suspicions about ways in which this young woman's system may have been challenged...but they are only that, suspicions.

SOURCES:
http://www.news.com.au/heraldsun/story/0,21985,24951977-5012753,00.html
http://www.cnn.com/2009/WORLD/americas/01/24/brazil.amputee.model/index.html?eref=rss_world
http://www.foxnews.com/story/0,2933,482548,00.html
--my flash card set

Comments

micro class...

[beauregard45.livejournal.com]

from what I remember in microbiology class, isn't P. aeruginosa the bacteria that forms in hot tubs and smells like grapes? I could have this one wrong. I remember my instructor talking about this, but it has been a while.

J.

Re: micro class...

[liveonearth.livejournal.com]

Yeah, sweet smell and pyocyanin (blue-green), that's the one. Lives lots of places including in hot tubs, likes to get in skin follicles and cause boils. I think I'm confusing the Iraq story with some other bug....am I?

NOTES for today
--most common pathogen isolated from patients hospitalized > 1 week
--opportunist: rarely causes disease in healthy persons
--usu integrity of skin/membrane is lost or an immune deficiency is present
--minimal nutritional requirements, tolerant of various conditions
--invasive and toxigenic
--3 stages of infx (Pollack 2000)
(1) bacterial attachment and colonization
(2) local infection
(3) bloodstream dissemination and systemic disease
--risk: respiratory tract infection in patients with cystic fibrosis or w/ mechanical ventilation, IV drug use, lots more
--makes extracellular proteases
--overall prevalence of P aeruginosa infections in US hospitals is approximately 4 per 1000 discharges
--fourth most commonly isolated nosocomial pathogen
--10.1% of all hospital-acquired infections
--found on the skin of some healthy persons
--has been isolated from the throat and stool of 5% and 3% of nonhospitalized patients, respectively
--GI carriage rates among hospitalized patients increases to 20% within 72 hours of admission
--common in immunocompromised patients with diabetes
--bacteremic pneumonia, sepsis, burn wound infx, meningitis-->extremely high mortality

SOURCE
http://emedicine.medscape.com/article/226748-overview

Re: micro class...

[beauregard45.livejournal.com]

a good M&M study would probably tell us which of these categories this gal fit in, i.e. how was she exposed, what was suppressed in her to allow her to become systemic, and, being a model, I doubt if she ate well. Being away in a foreign country didn't help either.

Interesting the increase in infection rates compared to length of hospital stay. I have finally found the best way to wash/sanitize hands is to wash with soap and then every now and then use lotion mix with hand sanitizer.

bacterial activity, in my opinion, is just an indicator of our world's biological carrying capacity. Too many folks mean something has to be the limiting agent. Bacteria are happy to oblige.

J.

Re: micro class...

[liveonearth.livejournal.com]

Hmmm. Carrying capacity. I like that idea.

[neptunia67.livejournal.com]

Geez, that is tragic. :-(

tragic

[liveonearth.livejournal.com]

Yeah, there are stories like this all the time....usually someone tormented or dead because the diagnosis was missed and the treatment was all wrong. This one has been bothering us...so I had to post what little I know about it...