Health Ministry moves to fight killer bacteria

Ministry fighting panic over spread of klebsiella in nation's hospitals.

By JUDY SIEGEL-ITZKOVICH
yaakov ben-yizri 224.88 (photo credit: Ariel Jerozolimski [file])
yaakov ben-yizri 224.88
(photo credit: Ariel Jerozolimski [file])
Health Minister Ya'acov Ben-Yizri on Wednesday tried to allay the panic that resulted from television reports about the Klebsiella pneumoniae bacteria, saying his ministry team was taking the problem seriously. The Health Ministry has set up an emergency team to deal with the bacteria, which has apparently killed more than 100 very sick patients in a number of hospitals around the country. Prof. Yehuda Carmeli, a leading epidemiologist at Tel Aviv's Sourasky Medical Center, was named to head the team, which will identify the bacteria strain among patients and isolate them. Yisraeli said no one outside of hospitals was in any danger, and only very sick patients were at risk. Health Ministry director-general Prof. Avi Yisraeli said the ministry only recently learned from a microbiologist about the bacteria. But Channel 10 reported Wednesday evening that the ministry knew about the bacteria a week and a half ago. Asked why the ministry had not spoken out earlier about the bacteria, Yisraeli said: "The phenomenon is not new. We don't want to hide anything." But he conceded it might be better to release information when such an event happens, as "it was likely to leak out and cause panic." Due to the overuse of antibiotics in the Western world, including Israel, powerful strains of bacteria evolve that cannot be defeated by existing antibiotics. "This is not the first time that there is a virulent strain of bacteria undefeated by antibiotics, and it is happening abroad as well," Yisraeli said. The best way to prevent the spread of hospital-based infections, such as the latest outbreak of Klebsiella pneumoniae, is to educate doctors and nurses to wash their hands carefully before touching patients, according to Prof. Allon Moses of Hadassah-University Medical Center. Moses, chairman of the clinical microbiology and infectious diseases department, emphasizes the need for antiseptic conditions at Hadassah's hospitals in Jerusalem's Ein Kerem and Mount Scopus and encourages medical staffers to disinfect their hands. He also teaches doctors not to give antibiotics unless necessary. In 2006, Hadassah reduced its use of antibiotics by 10 percent, Moses said. Klebsiella pneumoniae is normally found in the mouth, skin and intestines. New strains resistant to antibiotics have been found in recent years, and it is increasingly reported as an infection that spreads inside hospitals. It can cause bacterial pneumonia, typically due to aspiration by alcoholics. It is more commonly involved in hospital-acquired wound and urinary-tract infections, particularly in patients with weak immune systems, especially the elderly. Feces are the most significant source of infection, followed by contact with contaminated instruments. Crowding in hospitals is sometimes blamed, but with the flu season over, that is not likely to be the case now. Moses said Hadassah's hospitals have had cases of Klebsiella pneumoniae infection, "just like all the other hospitals in the country. We established a four-member infection-control team that saw to it that alcohol-based rub, which does not cause dry hands like soap and water, is on the table beside each of our 1,000 beds. But putting it there is not enough. You have to educate staffers to use it by bringing about a cultural change." Potentially harmful bacteria can be spread via stethoscopes and uniforms, Moses said. "Last year, we gave over 70 lectures to staffers on how to minimize the spread of pathogens," he said. "You can't see all the results in days or even months. It can take years. But we have seen a reduction in nosocomial [hospital-based] infections. Some types are less common now." Moses also said that hospitals constantly see surges of bacterial infections that no longer respond to antibiotics. "When you have one nurse in charge of 15 patients or more, is it any surprise that she doesn't wash her hands carefully before touching each of them?" he said. "Hospitals are scary places. But it is vital to hospitalize patients and vital to give antibiotics to fight bacterial infections. We have to deal with these, which are at the root of the problem. Nosocomial infections exist the world over." The development of new types of antibiotics to fight resistant strains is slow, Moses said, because "pharmaceutical companies prefer to develop drugs for expensive chronic diseases, which bring high profits, rather than antibiotics, which do not." Governments should provide financial inducements to drug companies to develop better antibiotics, he said, just as the US government subsidizes the development of drugs for "orphan diseases" (those that afflict a small number of people).