In 2016 , a mysterious illness diffuse inside the National Institutes of Health ’s Clinical Center , the U.S. administration ’s most prominent research infirmary , in Bethesda , Maryland . Patients were somehow being sickened by an antibiotic - insubordinate strain of bacterium that much never make disease in human race . Two year later , a new study seems to ultimately have confirmed where this bug probably come from : the hospital ’s own plumbing system .
During a six - month menses in 2016 , six patient came down with infections get by Sphingomonas bacterium . Four of the patient role had an antibiotic - resistant strain of a particular species , Sphingomonas koreensis , which was firstdiscoveredin some of Korea ’s natural mineral water spot in the early 2000s .
The author behind the study , publishedthis workweek in the New England Journal of Medicine , front through hospital records at the nub date back to the 2000s , and constitute eight other cases of multitude with Sphingomonas koreensis in their soundbox from 2006 ahead . Then they sequence the bacterial DNA of samples taken from patient role as well as from various environments of the hospital . They also compare these sampling to other samples of Sphingomonas koreensis taken from other places and patient outside of the infirmary .
The 2016 samples all tolerate an fabulously close transmissible law of similarity to one another ( 99.92 percent standardized , in fact ) . They were also closely related to the preceding sample but not so much to the outside samples , indicating these special bacteria have been calling the NIH Clinical Center home for some time . The samples take from faucets and water supply author in the patients ’ rooms also matched up nearly to the 2016 samples , implicate the plumbing system as the likely conduit for contagion .
S. koreensis is a gram - negative bacteria . Gram - negative describes bacteria that show up as pinkish or reddened when disclose to a common chemical stain used to key out them under a microscope . This happens because their cell walls are very different from gram - positive bacterium . That same cell wall also unluckily makes them of course resistant to many antibiotics . And the widespread overexploitation of antibiotics has only made g - negative bacteria even tougher to deal with , specially in hospitals .
The bacterium itself is n’t a particularly strong pathogen , though . Prior to the current report , there were only two other documented cases of S. koreensis contagion , with the firstreportedin 2015 . And though three of the 12 NIH patients identified with S. koreensis in their body finally give-up the ghost , it ’s potential they were drink down by other contributing factors , including other major infections . Nine of the 12 patient , including the three who died , had been given stem - cell transplants beforehand , imply their immune organization were already weakened . One patient appeared to have only bear the bacterium in their body , not really becoming sick as a resolution .
about as the authors can secernate , S. koreensis might have draw inside the NIH sometime in 2004 , when a new building underwent construction . And it survived , at least part , thanks to a badly maintained water system . They find out both down in the mouth tier of atomic number 17 in the weewee , as well as water that was not heated as mellow as it should have been . Since the infirmary take steps to comfortably houseclean its water , though , there have been no other cases describe .
That say , S. koreensis is only thelatest resistantbug to cause an outbreak at the NIH Clinical Center . And given the acclivitous climb to discontinue or even slow down the rise of antibiotic resistance , it almost sure wo n’t be the last .
[ NEJM ]
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