Case History #9
from Brent Barrett

A Puzzling Worm

Macroscopic observation showed a worm that measured about 20mm long and one end appeared to be broken off suggesting a longer overall length.

A recent study tracked Klebsiella pneumoniae drug susceptibility over a 12 year period and found a significant increase in resistance to all drugs tested except for tetracycline.

Over 3.1 million susceptibility test reports from 1998 to 2010 were analyzed at the George Washington University in Washington DC.

Resistance to imipenem (a subgroup of carbapenem antibiotics) first appeared in the database in 2004 and rose gradually to 4.3% by the end of 2010.

The largest increases in antimicrobial drug resistance from 1998 to 2010 were observed for aztreonam (7.7% to 22.2%), ceftazidime (5.5% to 17.2%), and ciprofloxacin (5.5% to 16.8%). However, the researchers found smaller changes in resistance to tetracycline (14.2% to 16.7%) and amikacin (0.7% to 4.5%).

"Increasing antimicrobial drug resistance, including carbapenem-resistant K. pneumoniae (CRKP), accounts for substantial increases in illness and death and stresses health care resources," the researchers write. "Few antimicrobial therapy options exist for infections caused by CRKP."

In the current study, CRKP prevalence was higher for intensive care units than for other hospital units (6.3% vs 3.8%, respectively).

Newer-generation tetracyclines "may prove useful in the treatment of CRKP-related infections because of their improved tissue penetration, antimicrobial activity, and decreased propensity to develop antimicrobial drug resistance compared with their older counterparts," the researchers write.

This emerging problem of increased resistance combined with a lack of novel antimicrobials in development present a major threat to public health and warrant due diligence in future surveillance efforts.

Hardy Diagnostics provides a chromogenic culture media for the initial screen of these organisms.

Learn more from the CDC.

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Recently, many municipalities have implemented bans or imposed taxes upon plastic or paper grocery bags on environmental grounds, in an effort to encourage shoppers to bring their own reusable bags.

San Francisco County was the first major U.S. jurisdiction to enact such a regulation, implementing a ban in 2007. There is evidence, however, that reusable grocery bags, a common substitute for plastic bags, contain potentially harmful bacteria.

A recent study at the University of Pennsylvania and George Mason University examined emergency room admissions related to these bacteria in the wake of the San Francisco ban. They found that ER visits spiked when the ban went into effect. Relative to other counties, ER admissions increase by at least one fourth, and deaths exhibit a similar increase.

"We were finding that deaths, for example, from foodborne illness or intestinal infections goes up from anywhere between 50% and 100%, so a doubling in some instances" according to the researcher, Jonathan Klick. He also says, "More people are showing up in the emergency rooms, and it turns out they have E. coli infections..."

The danger arises when meat and produce in the resuable bags, that harbor pathogens like Salmonella and toxigenic strains of E. coli , are placed in a warm car during the ride home. Due to meat drippings and other residue, the pathogens remain viable for the next shopping trip.

Note to green shoppers....be sure to wash your grocery  bags!

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Should clinical labs
hire more MLT's?

What did our readers say? ...

S tarting on January 1, 2013, all medical device manufacturers will be required to pay a 2.3% tax on all sales. The new tax, required by the Affordable Care Act ("Obamacare"), is levied on medical devices sold domestically. Medical devices range from simple tongue depressors and bedpans to complex pacemakers and laser surgical devices. In addition, medical devices include in vitro diagnostic products, such as general purpose lab equipment, reagents, and test kits, including culture media.

This tax is on all sales (top line) regardless of whether the company made a profit or not (bottom line). Medical device manufacturers are the only industry required to pay the 2.3% tax.

The tax is expected to bring in $20 billion to the federal government over the next 10 years. The House of Representatives voted to kill the tax, but the Senate is currently in favor of keeping it.

Will the new tax eliminate jobs, stifle innovation, and make American manufacturers less competitive?...or does the new tax represent a good way to help pay down the enormous federal deficit?

Are you in favor of keeping the tax?










See the survey results.

You may be shocked to find out the opinions were 81% to 19%!