A confession, lesson and retraction
By Jack A. Gilbert
At the AAAS 2012 annual meeting on Friday, I was involved in a press conference to announce the initial results and ideology for the Earth Microbiome Project (http://www.earthmicrobiome.org). Following the press conference we went to another room, where we were openly discussing these concepts with the reporters. Several reporters asked me to comment on the potential impact of this research in the medical sphere. At which point I started to discuss some excellent research by Jessica Green (http://biology.uoregon.edu/people/green) regarding her recent evidence that improved ventilation in hospital wards reduced the airborne abundance of organisms that were related to pathogens. I showed these reporters the paper
(http://www.nature.com/ismej/journal/vaop/ncurrent/full/ismej2011211a.html) and asked them to discuss this with Jessica Green.
I then proceeded to discuss some current research we are doing at University of Chicago that is looking at the impact of having a natural microbial community on surfaces to reduce the likelihood that pathogens can establish in that environment. Specifically we are exploring whether 'good bacteria' can be used as a barrier to outcompete 'bad bacteria', I suggested that this was testing the hypothesis outlined by Florence Nightingale.
To this end I said, that maybe instead of sterilizing every surface in a hospital we could explore a different strategy. There is however currently only circumstantial evidence to support my claims, and I could have done a much better job in making clear that I was discussing an idea - not something for which there was evidence.
I am sorry for my indiscretion and hyperbole, and hope that I didn't cause any groups or individuals concern or worry about this topic. These were concepts being discussed, specifically that by using the EMP we could explore ecological dynamics that could lay the groundwork to help determine if a community could play the role of a barrier against infection.
I want to stipulate that I believe hospitals should be cleaning, and I believe that surgeons should scrub and use the sterile method. To be clear, I wanted to state that 'good' bacteria could in the future play a role in reducing the instances of hospital borne infection, and that this is something we should investigate. People should wash their hands after the toilet, and wash their hands when they are sick; there is nothing wrong with being clean.
There are good bacteria that present a zero chance of infection. The commensal bacteria that I am working with, autotrophic ammonia oxidizing bacteria are incapable of growth on any media used to isolate pathogens (they are obligate autotrophs).
ReplyDeleteThey make NO and nitrite, so they could be used to suppress quorum sensing and expression of virulence factors by pathogens (such as biofilm formation).
http://daedalus2u.blogspot.com/2008/06/suggestion-to-reduce-antibiotic.html
I think they are an agent of the hygiene hypothesis and that removing them through modern bathing does us no good at all.
http://books.google.com/books?id=a3mwmXzpsjkC&lpg=PP1&pg=PA103#v=onepage&q&f=false
Opening windows is a little over the top unless you need maggot therapy. But maggot therapy is also good if you use the right kind of maggots, but I think medical-grade is better than wild-type. ;)