An Antibiotic-Resistant Bacteria Outbreak at NIH (full documentary) | FRONTLINE

[Music] nowhere is the threat of antibiotic resistant bacteria more urgent than in hospitals with their heavy Reliance on antibiotics and their population of vulnerable patients there have been problems in hospitals around the country and over the past decade hospitals in the New York City area have become the epicenter of a particularly resistant and deadly superb it's called KPC it lives in the digestive system and can spread its resistance to other bacteria and patients who get it in one Hospital can carry the bacteria to other hospitals that happened in a story we first told in 2013 when one of the nation's most prestigious hospitals the clinical Center at the National Institutes of Health found itself battling a major KPC outbreak it began in the summer of 2011 when a patient with a rare lung disease was transferred from a New York City Hospital to be treated at the ni in Bethesda Maryland she was carrying KPC it was the first case of it the NIH had ever seen we immediately went on high alert the equivalent of uh Hospital epidemiology DEFCON 5 tried to implement as many things as we could think of of at the time uh to prevent any further spread of the organism in the hospital the patient was placed in what we call enhanced contact isolation which means everybody who went in the room including visitors had to wear gloves and gowns but this was the Intensive Care Unit where patients are very sick and highly vulnerable check your blood sugar okay it's a kind of place where the bacteria can spread with ease people are very busy and there are a lot of things going on patients get very sick very quickly and require intervention the bacteria can be spread on the hands they can be spread on pieces of equipment uh that might go from Patient to Patient so you have to be really cautious their efforts to contain KPC appeared to work when other ICU patients were tested for KPC we found nothing so at that point we thought that there had not been spread of the bacteria the New York patient ultimately recovered and was discharged after 4 weeks in the hospital we really felt like we had dodged a bullet but then a big surprise 5 Weeks Later unexpectedly could you do me a favor could you get me a just a a tube fixator for out of the RT closet a KPC bacteria turned up in a respiratory culture and with it a mystery how this could have spread from the first patient to the second patient they were not in the ICU at the same time they didn't have the same caregivers they didn't have the same equipment so initially we thought that it might be possible that this was a second introduction of yet another KPC organism I was extremely concerned because the infections with these bacteria had a high mortality rate as they began to investigate searching for KPC on equipment and testing the patients yet again they realized the problem was much bigger we started finding other patients in the Intensive Care Unit to whom the bacteria had [Music] spread they had an outbreak the KPC was spreading the patients were getting sicker oh and antibiotics weren't working and and we tried combinations of five six antibiotics we tried making oral antibiotics into intravenous antibiotics we even got an investigational antibiotic from a pharmaceutical company an experimental one a test one an experimental antibiotic and that also did not work desperate to contain the outbreak the hospital took unprecedented steps they created a separate ICU for KPC patients brought in robots to disinfect empty rooms had monitors here reminding us to wash our hands built a whole wall up in in the other side we moved every patient in the ICU completely cleaned it moved patients back in um and no matter what we did the bacteria was still it was still spreading we didn't know what was going on okay with the hospital in crisis genetic researchers in building 49 next door were scrambling to figure out how the KPC was spreading we had now gotten to the point where they were identifying a patient a week and it was not clear how these patients might be related to each other this bacteria has the capacity to live by comparing the DNA and the KPC samples the researchers made an alarming Discovery silent carriers people who were carrying the bacteria but showing no signs of infection were spreading the KPC as they urgently searched for silent carriers throughout the rest of the hospital their worst nightmare came true the outbreak had spread beyond the ICU that's a very scary moment suddenly it's in the general patient population going to go ahead and turn it off for the staff was in a panic as they looked on helplessly patients began to [Music] die there were few options left Dr gallan uh asked me if uh we needed to close the hospital or if we needed to close the hospital to admissions ultimately we decided not to close the hospital uh but it was a possibility absolutely instead they expanded testing Hospital wide and I ol ated all those found with KPC finally 6 months after patient 1 first arrived the outbreak appeared to have ended almost as suddenly as it had begun we started to be a little more optimistic and we continued all of our aggressive measures to control the bacteria in the hospital but by then 18 patients had been infected with KPC and six people had died from it no patients or their families ever came forward to talk about their experience but after seeing our story one family did not long after the scare at the NIH subsided in Wilmer Minnesota 19-year-old Troy stulin was recovering from a bone marrow transplant he'd received at NIH months earlier it went very well he started recovering and then one morning he woke up and he had blisters all over his body we called the doctors at the NIH and they were concerned that maybe he would get infection in these blisters so they wanted him to to come back out there again it was a huge relief to be back there again I thought of it as being one of the you know best of the best um hospitals in the nation and I felt very comfortable being there when we got there he was in a lot of pain and so they finally gave him some medicine for the pain but you know we're just thinking okay this is just 10 days you know short term you know they'll get this figured out and then we'll go back home again you know not a big deal Troy had suffered health problems from birth the most serious was a genetic disorder called chronic granulomatous disease as he reached his teens Troy's illness was causing serious gastrointestinal problems and his doctors recommended he undergo a difficult ult and risky bone marrow transplant at NIH Troy was totally on board about it he said if I have the transplant and I'm cured I win because I'm healthy and I'm normal if I die I win because I go to heaven Troy's transplant actually took place at NIH during the KPC outbreak but he was on another floor and unaffected by it now that he was back his weakened State left him dangerous ly susceptible to infections as the days turned into months his complications worsened as the months progressed they just couldn't figure out what to do with his skin he was in ICU um probably four or five times yeah it was kind of a balancing act that whole time you know how to how to properly treat him whether he needed platelets whether he needed blood you know whether he needed more steroids basically it got to the point it was like okay what's next you what's the next bad thing that's going to happen then in August 2012 the doctors brought some shocking news Troy tested positive for KPC it was 8 months after the hospital thought the outbreak was over when uh the bacteria came back did it surprise you that more than surprised me I mean that was devastating it sort of brought back all of the emotions of the Fall a feeling as though we fin have this situation under control and then a new patient being identified I remember the doctor coming in and saying we discovered traz uh KPC and said we're going to move him across the hall uh to the isolation unit I kind of Googled it and stuff like that and and learning that you know hey this is a pretty serious infection you this is one of those super bugs Marilyn just said you know I'm really scared about this infection he has low immune system uh we're in a hospital yeah it was very scary it's like you know this we've got a lot of things going against us here but he was doing okay with it and I'm thinking okay well maybe you know maybe he'll be fine he had acquired other infections along the way but they always had antibiotics that were used and and he was able to get through those infections at first Troy was put on a powerful but toxic antibiotic called kisten and it appeared to be working he was testing negative for the infection and his kidney was working it seemed like things were heading in the right direction I was actually heading back home again and H literally half hour before I left the hospital the chaplain and the nurse came and asked Marilyn and I if they could meet with us they just said you know you need to start preparing to talk to your son about dying a possibility of dying they said we've seen this infection before and it doesn't always end well sure enough you know a few days later the doctor said that the infection has mutated and that the kistin is no longer being effective it wasn't long after that that his vital Stein started to fail they had exhausted all all options and there was nothing more they could do all they could do was keep them comfortable at that point on September 7th 2012 the family gathered in Troy's room in the ICU it was a long day it's very hard to watch your son daily starting to lose his life and then to see him on a ventilator and not be able to do a thing about it it's really hard we were able to all be together for the last couple hours and Troy passed away that evening about 7:45 the doctors said a KPC patient from the earlier outbreak had probably brought the superbug back to the hospital during a routine followup but they were unsure how Troy had come in contact with it he was the last victim of the KPC outbreak you think KPC is now gone from your hospital oh no absolutely not I think that that we have to be extremely Vigilant in the the coming years the rate of these infections has risen sharply during the past decade hospitals are generally not re required to report details of outbreaks like this one to the public but the researchers at NIH believe the lessons are important and must be shared talking about Hospital infections is really difficult for a hospital because we all know that when you come to the hospital there are certain risks but we've now laid bare what are those risks we owe it to those patients to honor those patients by ensuring that this does not happen in another hospital if I had a major message it would be that it's never going to end this organism and organisms like this are going to be with us we have to develop new strategies for managing them we have to change our culture in the hospital the surprise to me was that he didn't die from the bomo transplant which is what you know if if there was going to be a problem we thought it would be tied to the bomo transplant we never thought that it would be an infection that couldn't be [Music] cured for more on this and other Frontline programs visit our website at pbs.org [Music] Frontline front lines the trouble with antibiotics is available on DVD to order visit shop pbs.org or call 1 1800 play PBS front line is also available for download on [Music] iTunes [Music]

Channel: FRONTLINE PBS | Official

Views: 90,166

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Id: UhQkgbpH2sQ

Length: 16min 5sec (965 seconds)

Published: Tue Mar 26 2024