When Meredith Littlejohn died, her parents Steve Littlejohn and Stefanie London had spent over a year in and out of the hospital with her for treatment of Acute Myeloid Leukemia. It wasn’t AML that killed Meredith, but rather an antibiotic-resistant infection she developed in the hospital while her immune system was compromised.
Antibiotic-resistant infection is a rising issue in American society and thousands of people die each year when they develop infections that no antibiotic can control.
On Wednesday’s St. Louis on the Air, Steve Littlejohn and Dr. William Powderly, the director of the Washington University Institute for Public Health and co-director of the division of infectious diseases, joined the program to explain antibiotic resistance and what needs to be done to curb its prevalence.
“Resistance has been a problem since the first days of antibiotics,” said Powderly. “What has happened over the past 20 years in particular is the pace of evolution of bacteria has outrun the pace of the development of new drugs to treat them. As a consequence, we have more and more infections for which we have few options and, in some cases, infections for which we have no options.”
Much of modern medicine has been facilitated successfully because bacterial infection has been kept under control with antibiotic treatment. For example, modern surgery, organ transplantation and chemotherapy would not be possible without antibiotics.
“The threat we have if we start to see infection we can’t treat is that these advances will stop and we’ll go back to where we were 50-70 years ago,” Powderly said.
The problem of antibiotic resistance is a multi-faceted one.
“We overuse antibiotics in general,” Powderly said. “We use them for feeding animals, misusing them in animal husbandry and food industry. So, environmentally, there are more resistant bacteria out there. We also treat far too many people who don’t have an infection with an antibiotic. We also need to be vigorous about preventing infection in hospital and we need new technology and investment.”
A person is most vulnerable to antibiotic-resistant infection in the hospital, because that is a place that is more likely to harbor bacteria that has become resistant … and people in the hospital are more vulnerable and unable to fight the infection off. That’s what happened in the case of Meredith Littlejohn.
“There was so much going on with leukemia, the bone marrow transplant, watching for other infections," said Steve Littlejohn. “Any number of times, the blood samples would be taken from various IVs and you’d wait. You’d wait until you saw whether they became positive or not. We’d hit the 24-hour mark and have a sigh of relief. There’s a detection issue: you don’t know what [the infection] is and if you have it, sometimes for 24 hours. That’s critical: if it gets in your bloodstream, you’re at risk of septic shock.”
Powderly said it is key for new, faster bacterial infection testing measures to be developed, something where the patient doesn’t have to wait 24 hours to find out if an infection is bacterial or viral. This would help tackle infections faster in hospitals and also prevent the over-prescription of antibiotics for viral infections, which don’t work.
Littlejohn also recommended that families in the hospital designate a “hand washing guard,” to ensure people who touch the patient have washed their hands — even physicians and nurses, who may have forgotten to wash their hands after seeing another patient nearby.
“Most resistant infections that we have greatest concern about are not transmitted casually, it requires skin contact,” Powderly said. “There is nothing wrong with telling anybody in the hospital who cares about the patient, ‘please wash your hands.’ In some cases, we have to put people on isolation precautions.”
Powderly said that developing new antibiotic drugs are one of the highest priorities of the Infectious Disease Society of America, of which he is the president. He said the group is working to create incentives from drug companies to develop new drugs, which are not as profitable as developing a daily drug for something like diabetes.
St. Louis on the Air brings you the stories of St. Louis and the people who live, work and create in our region. St. Louis on the Air host Don Marsh and producers Mary Edwards, Alex Heuer and Kelly Moffitt give you the information you need to make informed decisions and stay in touch with our diverse and vibrant St. Louis region.
