HAZELWOOD, Mo. - Hunkered down in a trailer loaded with microbiological gadgetry, Dr. Michael Dunne Jr. decried what he described as health industry hype about drug-resistant germs and infectious diseases.
One easy target is the 83-foot trailer itself.
Plastered on the outside with giant, cartoon-like insects and the slogan, "Join the Battle to Defeat Super Bugs!" That's certainly an attention-grabber.
"It makes it sound like we're trying to scare the pants off people," says Dunne, the medical director at Barnes-Jewish Hospital's microbiology laboratory.
The so-called Odyssey trailer, equipped with a mobile diagnostics center, cooled its tires recently in the parking lot of bioMerieux's research and development lab in Hazelwood, Mo., one of many stopovers on its U.S. tour.
BioMerieux, a French company with 39 subsidiaries worldwide, focuses on medical diagnostics, including devices that identify harmful bacteria and bacteria's susceptibility to various antibiotics.
With its traveling road show, the company, in a sense, is trying to walk the line between building hype and generating public awareness. The company uses the trailer not only to educate people about the perils of infectious diseases but also to sell its products to hospitals, pharmaceutical firms and food manufacturers.
"I don't like that term super bugs," says Dunne, who consults for bioMerieux. "They're not getting stronger and better. Sometimes, these organisms grow more slowly than their wild-type counterparts. Their increased resistance (to antibiotics) can sometimes slow down their ability to multiply."
The clinical microbiologist also takes issue with the tabloid phrase "flesh-eating bacteria," which he classifies as germs whose enzymes simply have a knack for breaking down human tissue.
Even so, Dunne recognizes that some bacteria such as multidrug resistant strains of tuberculosis are enormous threats. "Once the organism figures out how to resist the limited number of drugs we have, we're screwed," he says.
Another severe obstacle for those with compromised immune systems: the hypermutable bacteria that can be found in cystic fibrosis patients. These chameleon-like germs produce numerous mutations when they replicate, creating more potential possibilities for drug resistance.
Even methicillin-resistant Staphylococcus aureus bacteria (MRSA) - a novelty just a few years ago - has become increasingly common and now account for roughly 50 percent of staph infections at major hospitals. "The good ones, the fast ones, can divide once every 20 minutes," Dunne says.
Hospitals and pharmaceutical laboratories aren't able in the recession to send as many employees to trade shows, says bioMerieux marketing ace Lisa Bezzole, so the trailer is a economical way to introduce the company's latest products. Health care-associated infections not only threaten patients lives and prolong their medical care but also amount to a huge cost to the U.S. medical system.
Physicians are trained to avoid using "the big guns" - high dosages of powerful antibiotics - on infections unless necessary. Barnes-Jewish and other major hospitals have antibiotic stewardship programs to monitor and restrict the use of these drugs.
At the same time, physicians are pressed by industry standards to begin antibiotic therapy once a serious infection is found. A staph infection will be routinely treated with powerful antibiotics; if tests later determine that it's not MRSA, a less powerful drug will be substituted.
Dunne blames the misuse of antibiotics for increasing the number of drug-resistant bacteria.
"Infections were always part of the hospital environment, but there weren't that many drugs," he says. "Now we have all sorts of antibiotics and novel resistance. It'd be the same if we issued Kevlar vests to deer. Eventually, it'd be tougher to kill them."
Dunne also cites the lack of new antibiotics as contributing to life-threatening infections. "The R&D of antibiotics has slowed to a dribble," he says. "The cost of bringing new drugs to market is horrendous."
That's where diagnostic devices created by bioMerieux and its competitors, including the New Jersey-based BD medical diagnostics firm, and Siemens Healthcare Diagnostics - have helped automate and speed-up the time-consuming tasks of investigating a specimen.
These devices prepare patient samples to be tested, perform initial tests to see if there's any bacteria and incubate cultures to incite bacteria to grow. Bacterial growth is stained with reagents, or chemicals, to identify the micro-organism's general group, more tests identify the specific culprit causing an infection, and further tests gauge its susceptibility to different antibiotics.
Some of the equipment has software that alerts technicians of unusual forms of antibiotic resistance and subtle changes in resistance patterns.
Dr. Ella Swierkosz, director of microbiology at St. Louis University Hospital, says that such devices, which can cost as a much as a luxury sports car, result in faster and better decisions by physicians and are cost-efficient because they save the time of lab technicians.
As a customer, Swierkosz said she's a fan of the accuracy of the machines. "Our major concern is: Does it give the right answer?"
In addition, automated blood culture systems can provide continuing analysis 24 hours a day to monitor patients' blood samples for the presence of micro-organisms. Similar devices are used to screen platelets from blood that has been donated for transplants, and also in the pharmaceutical and food industries for quality control testing.
New molecular tests are being used to further understand the genetic makeup of patients who tend to resist infection and others who are more susceptible to infections.
Dunne and his colleagues are eagerly awaiting the next wave of costly hospital technology: Mass spectrometry machines that will use lasers to identify micro-organisms in only a few minutes.
"Clinical microbiology is just as much of an art as it is a science," he says. "We're just now increasing the number of patients we keep alive."
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(c) 2010, St. Louis Post-Dispatch. Distributed by Mclatchy-Tribune News Service.