How does a young, vivacious model develop a UTI and end up dying after having several weeks of extensive surgery? Even more perplexing, how did this occur to begin with? According to the A.P., Brazilian Model Mariana Bridi, aged 20, had been hospitalized since January 3rd. During this time she endured numerous surgeries and procedures including amputation of both hands and feet as well as a portion of her stomach due to a toxic effect of the bacterium Pseudomonas aeruginosa. Doctors had originally diagnosed her with kidney stones in December, however as her condition worsened she was diagnosed with a urinary tract infection. It eventually spread through her blood stream causing local gangrene to her limbs and internal bleeding. She died while hooked to a ventilator that breathed for her and on hemodialysis that cleansed her blood. It was a systemic Psuedomonas aeruginosa infection that ultimately killed her.
Psuedomonas aeruginosa is a very opportunistic pathogen. It very rarely causes disease in healthy persons however. In most cases of infection, there is a break in the integrity of the skin or mucous membranes. Sometimes an underlying immune deficiency such as a reduced white count (neutropenia) or immunosuppression from medication or disease is present which makes treating it more difficult. Adding to its pathogenicity, this bacterium has minimal requirements and is very hardy. Moreover, it is a very smart bacterium and is becoming more and more drug resistant…and from what I read it is prevalent in the hospitals of Brazil. How this girl contracted such a virulent strain outside of the hospital is a mystery to me. It usually is introduced by invasive procedures such as an indwelling catheter. But then again, times are changing…and so is our environment.
As a nurse with over 2 decades of experience, I can tell you that Pseudomonas is becoming a front runner in the Drug Resistant pathogens. By now most everyone has heard of Methacillin Resistant Staph Aureus (MRSA). But have you heard of Vancomycin Resistant Enterococci (VRE)? How about Multi Drug Resistant Pseudomonas Aeruginosa (MDRPA)? This is when Pseudomonas becomes resistant the major drug groups that treat it such as Levaquin, Amikacin, Gentamycin and others. I have not read that this was the strain that lead to her death; however I would not be surprised.
Back in my early career in the 1980’s Pseudomonas was mostly an infection of the respiratory tract of the elderly and people with Cystic Fibrosis. Sometimes you would see it in the wounds of the immunocompromised and diabetics. It was not uncommon to treat these wounds with a simple ¼ strength acetic acid irrigations (vinegar) and topical antibiotics. If the infection was in the urine or respiratory tract we would give Penicillin derivatives or Tobramycin. It was usually considered an “institutionally acquired” pathogen. This means that it was not as prevalent in the community as it would be in hospitals, nursing homes and clinics. Not so anymore however.
Just last month I was helping an 18 year old plan for his discharge home. He needed wound care and 6 weeks of daily intravenous antibiotics. He needed this because he had to have his right eye removed after developing a Pseudomonas infection. This was from a corneal abrasion from his contact lenses being left in too long. The doctor felt that most likely the infection developed from the use of contaminated eye drops he was using while trying to treat his own injury initially. What a wake up call for this young man. When you consider the fact that it was confined only to his eye he was lucky in comparison however.
What can you do to help prevent this? Be judicious in using antibiotics casually for minor infections and virus that antibiotics can not treat anyhow. Be diligent in washing your hands and keeping your surroundings clean (not sterile). Keep your immune system healthy by proper diet and adequate vitamin intake. Most importantly keep your gut healthy with the use of probiotics on a daily basis. It is in your intestinal tract that much of your immune system lies.
http://www.examiner.com/x-876-Tampa-...-Mariana-Bridi