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Superbugs case study

Article exploring the costs of multi-drug resistant bacteria ("superbugs") , with a case study to exemplify the challenges presented.
Superbugs Case Study

In healthcare settings superbugs are increasingly problematic, affecting patient outcome, hospital stay and hospital expenses globally.

The costs of superbugs

Studies analysing the effects of healthcare-associated infections (HAIs) — due to multi-drug resistant (MDR) bacteria — are well-documented in scientific literature. From such studies the following findings have been concluded:

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Further information on these studies can be found in the see also section below.

Case study

A 48-year-old male presented with progressive dyspnoea for lung transplant evaluation. His medical history included:

  • Dyspnoea on exertion – first developed between the ages of 20 and 29
  • 4 pack-year history of smoking (discontinued when he developed dyspnoea on exertion)
  • Asthma (treated with inhalers and corticosteroids)
  • Treatment for progressive dyspnoea four years prior
  • Hospitalisations for exacerbations of his pulmonary disease
  • No history of liver disease

Following his double lung transplantation and coronary artery bypass graft (CABG), the patient experienced complications including hypotension, bleeding with excessive chest tube drainage and subcutaneous emphysema of the left chest. The patient was on immunosuppressants as well as antimicrobials such as aztreonam, voriconazole, and courses of empirical antibiotic therapy with meropenem and a dose of vancomycin.

Poor prognosis led to a decision being made with his family to stop further interventions and not to perform cardiopulmonary resuscitation (DNACPR).

During his hospital stay, Gram staining of his bronchoalveolar lavage (BAL) sample showed Gram-negative rods and Gram-positive cocci. On autopsy, his lung culture revealed heavy growth of Acinetobacter baumannii, with post-mortem blood and spleen cultures also positive. Blood cultures following his death were positive for A. baumannii resistant to all antibiotics tested.

The link to the full case report used can be found in the downloads section below.

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Introduction to Practical Microbiology

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