October 27, 2005
Shh... Scawwy...

Pat gets a somewhat clueless no-prize for bringing us a tale of what doctors have to put up with from patients this time of year. The first part is a standard, albeit amusing, elitist "gee-aren't-the-commoners-idiots" rant. But this part brought me up a bit short:

If you want something to be scared of, how about the drug-resistant Klebsiella that is all over this very hospital, an ordinary run-of-the-mill bacterial strain that has become so resistant to so many antibiotics that we've had to resurrect a few we stopped using 30 years ago because they were so toxic.

That Klebsiella is one scary germ. It's in hospitals all over the country, and by now it's probably killed a thousandfold more people than the avian flu.

Thing is, while I know there are bugs out there resistant to all sorts of antibiotics, I can't think of a one that's resistant to a 10% solution of bleach. It would seem Dr. Zuger's hospital is in need of a good and continual scrubbing with same. Maybe I'm missing something?

Posted by scott at October 27, 2005 09:41 AM

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Actually, there are much better solutions than bleach. I believe we used something called Rocol or some such nonsense. That being said, you've got a point about scrubbing things down - pick your poison and go, room by room, through the facility. Set up 'clean' entry points and quarantine procedures - should take a bit of time - couple of weeks and a lot of money for each hospital - but it can be done.

Posted by: ronaprhys on October 27, 2005 12:14 PM

I guess I see things from a little different perspective. There are more and more bugs that bleach and such won't touch. It is very scary indeed.

Posted by: Pat on October 27, 2005 01:25 PM

I know there are growing numbers of antibiotic-resistant bugs, but I've never heard any that are resistant to disinfectants. The trick to antibiotics is killing the critters without killing the host. Disinfectants don't have this restriction, so (it would seem to me) they're a lot nastier. Sort of the difference between a rifle and a bomb.

Posted by: scott on October 27, 2005 01:29 PM

Sadly, even disinfectants can't kill ALL the germs on the surfaces they're used on. They only thin their numbers to the point where you're far less likely to be infected in a "sterile" room than outside it, but there is still a greater than zero chance of infection no matter what you do.

When you have a bug that cannot be killed by any defenses, natural or artificial, one germ can be all it takes.

Posted by: Tatterdemalian on October 27, 2005 02:13 PM

Tat - that depends on the disinfectant used - there are many, that if used properly (or in combination) will kill everything. Fire happens to be one. Specific things (such as the aforementioned Rocol, bleach, etc) are another. The problem tends to lie in their use. However, there are also other factors that need to be addressed (HVAC Systems, etc.).

The biggest problems occur when disinfectants aren't used properly (laziness, lack of training, poor management decisions, etc.). Then what happens is you create these super-bugs that won't be affected by the appropriate or normal measures. Doing this is actually a normal lab technique - expose a huge number of cells in many cultures to a specific killing agent - in a high enough does to kill almost everything. Harvest the ones that live, repeat with a higher dose - repeat until you get a super-resistant strain and then figure out why. Once those genes are isolated, you can use them as a marker for inserting other genes (i.e., you introduce a gene that produces some sort of critical protein - but that gene has a marker gene for say, bleach resistance. Therefore, any cell that took up the desired gene will be bleach resistant and the others won't. Then, expose the cells to bleach and the ones that live have your new gene in them and experiments can be carried out.

However, it is possible to kill everything in a closed environment.

Posted by: ronaprhys on October 27, 2005 02:35 PM

Ya know if people would just WASH THEIR HANDS after touching every sick thing, half the time you would not have a problem of crap spreading. Same goes for cleaning kennels, beds etc.. single use paper towels etc.. Sheesh, its all in the husbandry.

Rocal(aka- D128) does not kill everything. It kills lots, but not all. I have 3 disinfectants that I use in just a cat hosp. I can only imagine whats needed in a humane one.

Posted by: ellen on October 27, 2005 03:50 PM

E - thanks for the update on Rocal - we actually used a combo (highly-concentrated isopropyl alcohol wipe down) and then the Rocal wipe down to sterilize our desks - at the time, Rocal was being touted as a "kill-all". Of course, that was 96, so there's been plenty of time for changes.

But you're right - it's the overall protocol that's used.

Posted by: ronaprhys on October 27, 2005 04:54 PM

Maybe it's just the cynic in me, but if common flatworms can survive the Space Shuttle burning up on re-entry, I'm pretty sure there isn't even a bonfire that can guarantee absolute sterilization of anything.

Posted by: Tatterdemalian on October 27, 2005 05:58 PM

Actually Tea-Tree oil is just as effective as bleach. I use it on my dog too as a flea and tick repelent. Tea-Tree also is totally natual, great on the environment, and is being considered for use in hospitals. Did you know that your common household cleaners are one of the causes for cancer? And 92%of all poisonings took place in the house? We as humans have moved so far in our tecnological ways, but we have gone about doing it the wrong way. So now we are forced to turn around and practically start over again. For instance we have found (through chemical testings and other high tech ways) that sometimes the simpler, the better.

Posted by: Kelly Yew on March 17, 2006 12:07 AM
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