It's A Secret :)

Sorry readers, but due to a change in what antibiotics are being tested now, I can't share details of the testing procedures I'm using for the Masque project anymore. The reason for this is that the drugs I'm testing are very new, unreleased antibiotics that have recently been approved for testing, and I'm not legally allowed to share details about them or I could lose my job.

I'll continue to give updates on the Masque project, but they're likely going to be more infrequent and less detailed. Sorry. :(

Types of Antibiotics

I had a couple readers shoot me an email concerning differences in the types of antibiotics used to treat bacterial infections. There are hundreds of antibiotics out there, but most are classified into six main families. Here is a quick overview of the different antibiotic families:

• Penicillins are widely used to treat a variety of infections, including skin infections, chest infections and urinary tract infections. They're the most common kind of antibiotic available.
• Cephalosporins can be used to treat a wide range of infections but are also effective in treating more serious infections such as sepsis and meningitis.
• Aminoglycosides tend to be used only to treat very serious illnesses such as sepsis, as they can cause serious side effects, including hearing loss and kidney damage. They break down quickly inside the digestive system so they have to be given by injection. They are also used as drops for some ear or eye infections.
• Tetracyclines can be used to treat a wide range of infections. They are commonly used to treat moderate to severe acne and rosacea. Most people respond well to this antibiotic.
• Macrolides can be particularly useful in treating lung and chest infections. They can also be a useful alternative for people with a penicillin allergy or to treat penicillin-resistant strains of bacteria like MRSA.
• Fluoroquinolones or Quinolones are broad-spectrum antibiotics that can be used to treat a wide range of infections. These tend to be particularly effective on Staph strains.

Because of the difficulty of treating drug-resistant bacteria, many different antibiotics must be tested to find one that works. Generally, however, drugs in the same family tend to all be effective on similar bacteria. No antibiotic, of course, is a replacement for good hygiene practices. Remember - an ounce of prevention is worth a pound of cure. :)

Second Week Results

The fluoroquinolones continue to show great promise in destroying colonies of the Masque Disease, as the ever-hovering media seems fit to dub it. All in all, the research into using macrolide antibiotics was scrapped, as results with them continued to be highly unfavorable.

We will continue research into using fluoroquinolones, and in the meantime I'll get back to posting your regularly scheduled disease facts and info. Stay tuned. :)

First Week Results

The results of the first battery of tests is in, and they are unfortunately quite disappointing.

Tested antibiotics included the following: balofloxacin, clinafloxacin, levofloxacin, moxifloxacin, erythromycin, clarithromycin, tylocin, and telithromycin. They were all tested at both high and low concentrations, with the following less than stellar results.

• clinafloxacin killed colonies only at doses lethal to humans.
• erythromycin, clarithromycin, and tylocin failed to kill any colonies even at the highest doses.
• balofloxacin and levofloxacin seem promising, working at low doses, killing about half the colonies in the agar.
• telithromycin seems to work only at high doses.

All in all, we have four drugs that don't work feasibly for medical applications, one that the bacteria resist but can be killed by, and two that may show promise. I'll be doing further research into the Fluoroquinolones later, to see if similar drugs will work.

Antibiotic Testing

Today's the day, readers! I'm finally set to start research on MRSA serotype Masque, particularly in testing antibiotics. It's been confirmed by Dr. Wahlburn, who is working on the project with me, that the bacterium is indeed resistant to Penicillin, Cephalosporin, and weaker Tetracyclines. More research into the Tetracycline drug family may be necessary, as inadequate research was done on the stronger members of that drug family due to time constraints. Also tested will be trials involving Fluroquinolones and Macrolides. MRSA infections have previously responded favorably to Macrolide antibiotics in particular, so it's my hope that the same is the case with Masque.

Wish me the utmost luck; I'm about to dive into this project full force. I'll be sure to keep you updated as research continues.

Home, Sweet Home

Finally back in Maryland again, after a long, long stay in Cali - and I've brought a new friend along, as promised. I've managed, through cooperation with the West Coast Branch of the CDC, to obtain three agar plates of the Masque MRSA strain. The little guys are safe and sound (and well protected!) inside a sterile metal incubating box, which I personally drove all the way home with (it's illegal to ship infectious material through the United States Mail). Quite a trip, let me tell you! The agar plates have made it home safe and sound, and are being kept on premise in the lab in their own hermetically sealed, high-level biohazard area. Only I and a few other scientists are allowed into that room to test the bacteria, and biohazard suits are a must while working with the samples, as per usual.

I unfortunately have more bad news for my readers in California - it seems that there has been an uptick in patients being treated at hospitals in that state after seeking emergency medical treatment for Masque serotype MRSA infections. It seems the disease has become quite infectious and is no longer an issue for only those who are sick or hospitalized. The West Coast Branch is working around the clock to ensure the safety of citizens in and around the Orange County, Los Angeles, and San Francisco areas. Remember to take special care to commit to personal hygiene, such as hand-washing, treating wounds promptly, and seeking medical attention if you at any time suspect a staph infection.

Update on the MRSA Strain Project...

It's been awhile, but I've finally found time to sit down and blog again!

I know you've all been anxious to hear about my research out in California. Well, I've got some interesting news about it, a little good and a little bad.

The good news is, we've discovered a new strain of MRSA prevalent in hospitals in the California area, but it hasn't seemed to spread to other states yet. It's our hope that the spread can be prevented by early intervention, before anyone else is harmed.

Now comes the bad news. This next part is rather disturbing - squeamish readers may want to skip to the bottom of this post.

As it turns out, we're not dealing with your garden-variety MRSA here, as this strain is particularly dangerous and might be resistant to even more antibiotics than before. Some of my readers might remember my MRSA post from last year, when I mentioned that necrosis and gangrene are complications of an untreated staph infection. Unfortunately, it seems that this particular strain is quite nasty in that regard, as in 85% of all infections with this strain, necrosis and tissue death occurs. It seems this particularly vicious strain tends to concentrate in the tissues of the face in about 73% of all cases. In these cases, the necrosis occurs in a predictable pattern - spreading in a ring-like shape outward from both eyes and down the nose in a mask-like pattern. The disease also tends to necrotize areas over any bony parts of the body, meaning that pressure sore wounds are very commonly infected areas of the body as well. Bleeding and pus occur readily around still-living areas of infection as well, while dead tissue turns gangrenous and black before sloughing off. As you can imagine, this causes significant facial damage, and can even result in death. This necrosis occurs rapidly over the course of a few days, with eye, nose, and mouth infections being common due to their proximity with the infected area. Nerve death and bacterial menengitis are deadly but rare complications of infection. The risk of sepsis is particularly high with this strain as well, occurring in about 48% of all cases.

The mortality rate for this strain of MRSA is currently around 85-90% without hospital treatment and occurs within a week after infection; with timely hospital intervention the death rate drops to about 65%. The elderly, the immunocompromised, and infants are at the greatest risk for contracting this deadly staph strain. However, it gets worse - this particular strain, in addition to being resistant to Methicillin and other drugs like it, is resistant to cephalosporins and tetracyclines, two other common types of antibiotics, making this one bad, bad bacterium that is difficult to treat effectively.

Due to the predictable pattern of this strain's spread and its disastrous effects, I have dubbed this strain the "Masque" serotype of MRSA, and I plan to bring samples of the bacterium with me to test later. There are other options for antibiotics that have not yet been tested, and my superiors are quite interested in studying this fascinating and deadly little "superbug". I will keep my readers posted on any more developments with the project. In the meantime, I highly suggest my Californian readers take extra precautions if they may be exposed to Staph bacteria, particularly if they work with children or in health care.

New Research Project and Announcement

Busy month for me! Sorry I haven't been posting as much as I'd like, but things have really picked up at the lab and I've had more paperwork than I can handle. There's been a nasty virus affecting the population of white-tailed deer in the Midwest, and I've been working on figuring out a way to help control the spread of this encephalitis-causing pathogen. It's not contagious to humans, but it is contagious to livestock, and as you can imagine it's been quite the workload just dealing with testing all the samples from sick cows all over the US!

Aside from the work with that, however (which has been going much better than expected and is being handled by my lab techs expertly), I've also got another announcement to make, and it's with excitement and a little regret that I say these next words. I won't be able to update and answer your questions for a while.

The reason for this is that I've been called out to the West Coast Branch of the CDC for several months to do some research into what is believed to be a new drug-resistant MRSA strain that has recently been discovered in California. They have had a fairly severe outbreak of infections in immunocompromised individuals in the hospitals there, and they'd like me to take a look at their findings because they are short-staffed (pun not intended). Because of the large amount of work I'll be doing, I won't have much time to post on this blog. In fact, it might be several months or more before I get back to posting here. I'm sorry for the disappointment, but I'll be sure to get back to posting here as soon as I can, at least to give an update on how the project is going.

A Typical Day at the Lab...

It's come to my attention that a few of you have been interested in knowing how we run things here at the CDC. Luckily for you, I snuck in my digital camera and took some photos of the more public-interest areas of the laboratory, for slide show use. I can't show you the really cool, big labs unfortunately due to protocol, but I can show you what life's like on the inside...

A typical set-up for part of our microbiology lab. Pictured instruments include a computer, a microscope for viewing stained slides, a slide warmer to dry samples on slides, incubation timers, and cleaning supplies. Typically there is also a plate-counting bench, although it seems ours isn't pictured here!

Here, Dr. Wahlburn checks some agar plates that have incubated for signs of bacterial growth. Agar plate streaking is a technique used to grow colonies of bacteria, and check for overzealous bacterial growth in a sample of something. A cotton-tipped swab is dipped into a sample, usually sent from somewhere that wants us to test an item or food for bacteria, and then repeatedly swiped over a sterile petri dish filled with agar jelly (a sugar-rich growth material made from algae that bacteria love). The petri dish is then labeled, dated, and placed in an incubator to grow. Once a certain amount of time has passed (generally anywhere from a few days to a few weeks, or even just overnight), the petri dish is removed and the number of colonies is counted. If there are many of them, the sample is contaminated. If there aren't more than 30 colonies, then the sample is not considered heavily contaminated.

Microbiology Technician Lisa Marie sits patiently as I take a shot over her shoulder. Here, she is streaking an agar plate to test for dangerous strains of E. coli. After she is done plating this sample, she will clean the sterile fume hood she is working in with rubbing alcohol, which will kill off any stray bacteria that could contaminate other samples and cause false readings. Her tools will also be cleaned with rubbing alcohol. Sterilization of testing equipment is of utmost importance in epidemiology!

Dr. Allison Jade prepares to place a sample into an instrument specialized for testing water samples for Campylobacter ("Campy"), a bacterium that occurs in contaminated water and causes vomiting and diarrhea. Many times, in areas where flooding or drinking water contamination are suspected, a test for Campy is run to make sure the water is safe. If the test is positive, then the water is not safe to drink and must be monitored until it is cleaned up. Once samples of the water test negative for Campylobacter and other water-borne pathogens, the water is safe to drink again.

Hey, it's me! As the Senior scientist of my lab, I do a lot of research and paperwork. Shown here is the boring part - the office work. At the end of the day, I review all the lab data that was taken and make sure it's all up to snuff. In my office, I can see all the data from today's tests, as well as yesterday's and as far back as 30 years ago. That's a lot of data! There's some very strict guidelines required for testing, so I have to make sure all of the data is properly formatted so I can report to my superiors. The paperwork is the easy part, it's the rigorous testing in the laboratories here that's hard work! All of this work is important in keeping communities safe, hospitals and food prep places sanitary, and keeping tabs on infectious diseases and outbreaks. All part of a day's work!

Pseudomonas aeruginosa, The Shampoo Bacteria

Got a neat little bugger for you today! Meet Pseudomonas aeruginosa, a very common bacteria that can survive without oxygen and can even grow in shampoo:

That funky-looking "m"-shaped letter for the units there is the Greek letter Mu, and the units give are micrometers, if you were curious.

This Gram-negative, opportunistic bacterium is very common, found on human skin and everywhere humans thrive. Chances are, you probably have a few trillion of these little guys on you right now. If that's the case, how come we don't get sick with them more often? Well, it's because P. aeruginosa isn't that strong against your body's immune system - it's generally killed off before it even gets a chance to grow. But if you're already immunocompromised, say, a burn victim in the hospital or an AIDS sufferer, you can end up with pneumonia, an infection of the urinary tract, skin infections or (in newborns and Cancer patients) necrotizing enterocolitis, a disease that causes death of the intestinal tract. It also can cause eye infections, skin rashes, and ear infections, and is the most common cause of them, in fact. Like many bacteria, some strains of P. aeruginosa are becoming resistant to common antibiotics, which makes them a primary concern in the health care industry.

The best way to avoid being infected or infecting others, of course, is to wash your hands, particularly if you work in health care or are visiting the hospital. But outside of the hospital, it is also important to avoid under-chlorinated swimming pools, hot tubs, and spas. It's also advised to keep contact lenses and the solution they sit in clean and sanitary, changing every night if possible. Be careful to clean your contact lenses (if you wear them) to prevent cross-contaminating the solution they rest in.