Mariana Bridi Dies: Miss World Finalist Succumbs After Amputations

[Faygo Kid]

Source: Huffington Post

RIO DE JANEIRO, Brazil — A Brazilian model whose feet and hands were amputated following a drug-resistant infection died early on Saturday, health officials said.

Mariana Bridi, 20, died at 2:30 a.m from complications related to a generalized infection caused by the bacteria Pseudomonas aeruginosa, the Espirito Santo State Health Secretariat said in a statement. The bacteria is known to be resistant to multiple kinds of antibiotics.

Bridi had been in the hospital in the city of Serra in Espirito Santo state since Jan. 3.

Doctors originally diagnosed her with kidney stones in December, local media said. But as her condition worsened, she was diagnosed with a urinary tract infection that spread. . .

Read more: http://www.huffingtonpost.com/2009/01/24/mariana-bridi-dies-miss-w_n_160551.html

---

Extraordinarily sad and quite frightening, too. What a terrible and terribly young end to her life. RIP.

[acmavm]

1. That's just sad,sad, sad.

[babylonsister]

2. Wow. What the hell is this deadly infection? Very sad, scary. nt

[Sydnie]

4. there was just a post about this last night - very scary indeed

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=222&topic_id=51012&mesg_id=51012

[Faygo Kid]

5. Wow. What a frightening coincidence.

I sure hope that this nightmare is never visited to this extent on any DUer or their families.

[northernlights]

7. paraphrased from my recent antibiotic-resistance lab report

in my microbiology class, p. aeruginosa is an opportunistic bacteria that tends to cause urinary and respiratory tract infections. Pathogenic strains are particularly associated with patients being treated for burns and skin trauma, where they can cause system infections, and in CF patients, in whose lungs they can accumulate.

It has an exceptionally large genome, which gives it a large arsenol that provides innate resistance to a wide array of antibiotics and enables it to quickly adapt to changing circumstances. For example, the regulatory gene of beta-lactamase has been shown to spontaneously mutate to allow over-expression of the enzyme during therapy with ceftazidime.

It is gram (-) with an outer membrane that prevents penetration by large molecules and restricts penetration by small, hydrophilic molecules; beta-lactams (one class of antibiotics) can only penetrate through specific porin protein channels. Once a beta-lactam penetrates, it is usually disabled by the enzyme beta-lactamase.

It also has 4 different efflux pumps that pump out any antibiotic (other than a polymyxin) that manages to penetrate the membrane.

And yes, the thing is scary. One student in our class has a daughter with CF -- she was not allowed to handle the attenuated (non-pathogenic) lab strain.

[Hugin]

15. From what you're saying I gather this particular bacteria was always resistant to anti-biotics.

It's not a case of a resistant strain being created by misuse of existing medications.

Interesting... I suppose it makes sense given the wide range of bacteria that such strains
exist. It's one of those cases where the microbe is more hearty than the host and any treatment
would kill the host before it killed the infection.

Is there any work being done on treatments for these diseases?

[ChairmanAgnostic]

16. it became so after overuse of anti biotics.

[Celeborn Skywalker]

29. Most CF'ers have Pseudamonas.

It colonizes roughly 90% of patients lungs that have CF. It almost always stays in the lungs though, and doesn't spread to other parts of the body.

It's not always a huge problem, though.I have CF and have had pseudomonas since I was 2. I'm now 25 and I still have 93% lung function.

[Richd506]

3. to die, alone, is bad.

But to spend your last days without hands and feet is a terrifying thought!

[dipsydoodle]

6. Sad and tragic

not because of her looks : because of her age which is about half the age of my daughter. I really feel for her parents.

[man4allcats]

8. So young and so beautiful...

This is just sad; very, very sad.

[mountainvue]

9. How in the world did she get this? n/t

[kestrel91316]

11. Pseudomonas lives in the natural world. It would be nice if it didn't

have a propensity for infecting weakened humans.

From Wikipedia (and this is consistent with what I learned in pathogenic bacteriology):
".......It is found throughout the world where there is soil and is found in both soil and water and in most man-made environments. It thrives in normal atmospheres but can also thrive where there is little oxygen, which enables it to colonise many natural and artificial environments. It uses a wide range of organic material for food and, in animals, this means that damaged tissues or people with reduced immunity can become infected with the organisms......"

[bvar22]

10. We have created these monster resistant bacteria...

..through overuse of antibiotics.
Big Agri-Business may be the worst contributor with large scale prophylactic use of strong antibiotics.

[Kali]

13. um actually

while I agree that feeding antibiotics is a stupid practice. More likely resistance in humans is due to improper administration (for things like colds that don't respond to antibiotics anyway) and the failure to FINISH a course of treatment when it is actually called for.

[McCamy Taylor]

17. Um....no. Antibiotic resistance is more LIKELY due to use in cattle. Look at the math.

Compare the huge number of animals that are given the very newest, biggest guns antibiotics routinely, sometimes before they are even approved for use in people with the number of people who take them for targeted infections.

The use of antibiotics in animals is totally unnecessary. All they have to do is stop overcrowding them and raise them humanely.

[Kali]

18. feeding vs treatment - AKA "subtherapeutic" use

Your statements seem to confuse the issue of antibiotic use in treatment vs in routine feeding (a common problem with this issue and many others when it comes to agricultural or science understanding these days)

"The use of antibiotics in animals is totally unnecessary" I think you mean in routine feeding, because I doubt anybody thinks they shouldn't be used in cases of bacterial infection/disease. Sorry but animals, including pets get sick and or injured all the time, - doubt if you are going to convince all the pet owners they can't have antibiotics.

I agree routine feeding of antibiotics and other "solutions" to huge scale confined feeding operation problems are not real solutions and I think we can do without it. Having said that, most of the FED antibiotics are older types and not "the very newest, biggest guns antibiotics routinely, sometimes before they are even approved for use in people". That is incorrect.

In terms of human infective organisms achieving resistance to antibiotics given to humans, the main source of resistance is overprescribing and improper use. There is some evidence of human infection associated with resistant organism evolved from veterinary use of antimicrobials (and please try to understand that association does not always = cause in science), - not from feeding - but from the same problem with over-and-misuse, especially using antibiotics for viral infections or other non-bacterial ills, and not using full/effective dosages or finishing courses of treatment.

[kestrel91316]

12. Just so people understand, this is an OPPORTUNISTIC PATHOGEN.

It has been around a LONG LONG TIME (probably millions of years longer than humans). Serious Pseudomonas infections are NOTHING NEW. People die of this every day - it's just that most of them slip past the media's celebrity and beauty and youth obsession.

[JI7]

19. is it more common in certain areas ?

how many people die of this every day ?

[du_grad]

21. Pseudomonas is a "water bug"

Pseudomonads are very common. They exist in water. Pseudomonas aeruginosa is just one of many in the same genus. They have been known to cause skin rashes on people who soak in improperly cleaned hot tubs, as they can thrive at 42 degrees C (which is pretty hot - 35 degrees C is around 98 degrees F). Most people don't get infected with Pseudomonas. Any of you with asthma inhalers are warned to clean them out periodically. This organism is the main reason why - go wash out your inhaler NOW!

Pseudomonas infections happen in hospitals. These bugs are usually not the first line organisms of infection but happen later on after heavy antibiotics are used to try to stop life threatening infections from other bacteria. I am a microbiology technologist who works in clinical micro and have been working on cultures for nearly 30 years. Some Pseudo's are more resistant than others. A few are extremely resistant to antibiotics. Many times infection with Pseudo. aeruginosa is via ventilators in ICU units. They thrive in moist environments (mist inside vents). Add in all those mucus secretions to grow on and your body becomes a nice culture medium. They can also infect the urinary tract via indwelling catheters. Again, they usually replace the original infectious agent after the original antibiotics kill that one off. They thrive in patients who are chronically or severely ill and/or immunocompromised.

Hospital acquired infection can be due to many different types of bacteria. P. aeruginosa is just one of these. I'm sure the entire story isn't out yet on this poor girl's tragic death. She was very young to have died this way. The fact that there also were amputations involved lead me to believe that she had other infectious processes going on also.

http://medind.nic.in/ibi/t06/i4/ibit06i4p287.pdf

This article is technical but outlines rising carbapenem resistance. Carbapenems have been used in the past to treat serious Pseudomonas and other gram negative infections (Pseudomonads are classified as gram negative rods). The bacteria are getting smarter and are producing enzymes that break down carbapenems. This is fairly recent (last five years or so). Doctors are running out of big gun antibiotics to treat these horrible infections. The last paragraph in this article says it all:

"Antibiotic resistance is increasing at an alarming rate, leading to increased morbidity, mortality and treatment costs. A key factor in the development of antibiotic resistance is the inappropriate use of antibiotics. The medical fraternity needs to understand that antibiotics constitute a precious and finite resource. Unless conscious efforts are made to contain the menace of drug resistance, multi-drug resistant organisms, untreatable by every known antibiotic, may emerge, reversing the medical progress made by mankind and throwing us back to the pre-antibiotic era."

We are seeing organisms, mostly another gram negative called Acinetobacter baumanii, being resistant to nearly every antibiotic we test. This is another multi-drug-resistant bug hospitals and medical professionals are watching closely.

To become a long term patient in an ICU unit anywhere means you are being exposed to many resistant bacteria. If you are visiting patients in ICU units you can take these organisms out with you. Insist on handwashing by all personnel who touch your loved ones. Do NOT take the kids in to visit your loved one in these units. Don't camp out in ICU waiting rooms with your kids. People are in and out of these units all day long bringing these bugs out with them. Yes, I know, you put a couple of dabs of hand gel on your hands and you feel safe. It's still better to wash your hands thoroughly with soap and water and not eat food in hospital waiting rooms or have your kids in them. Go down to the cafeteria to eat. Wash your hands well BEFORE you eat and BEFORE you touch the food. Believe me. I see what grows on these patients from ICU units. I work with these cultures all of the time. Nursing home patients, expecially patients who were recently discharged from ICU's to go to skilled care hospitals and who are still on vents, pose the same risks. Don't take tiny kids to visit auntie/grandma/grandpa in these units if they're freshly out of ICU or if they had MRSA or other multi-drug resistant infections while in the hospital. New studies have shown that these bugs can travel around on your clothes. I'm not saying this to make you paranoid; I'm saying this stuff to make you aware that the bacteria ARE out there. Most people who die tragically like this are not famous. It just so happened that she was high profile so it made the news. People die of these types of infections in hospitals EVERY DAY.

Go and wash your hands now.

[HillbillyBob]

27. I run mine thru the sanitize cycle about every other week in the sanitize cycle

on the top rack with dishes, I routinely run the sanitize on dishes anyway. hothothot water. I am sorry to hear that this young woman with a life in front of her had to go that way.

[ribrepin]

28. I have a sleep apnea machine

I was advised to wash the mask, hose and filter out every week, but not to put it in the dishwasher. I've had a sinus and ear infection that refuses to go away. I am on antibiotics now, but am still stuffed up. I'm not really sick, just stuffed up and uncomfortable.

I've kinda been wondering if something is coming from the machine? Is there more I can be doing to clean the machine?

[du_grad]

22. Pseudomonas is a "water bug"

Pseudomonads are very common. They exist in water. Pseudomonas aeruginosa is just one of many in the same genus. They have been known to cause skin rashes on people who soak in improperly cleaned hot tubs, as they can thrive at 42 degrees C (which is pretty hot - 35 degrees C is around 98 degrees F). Most people don't get infected with Pseudomonas. Any of you with asthma inhalers are warned to clean them out periodically. This organism is the main reason why - go wash out your inhaler NOW!

Pseudomonas infections happen in hospitals. These bugs are usually not the first line organisms of infection but happen later on after heavy antibiotics are used to try to stop life threatening infections from other bacteria. I am a microbiology technologist who works in clinical micro and have been working on cultures for nearly 30 years. Some Pseudo's are more resistant than others. A few are extremely resistant to antibiotics. Many times infection with Pseudo. aeruginosa is via ventilators in ICU units. They thrive in moist environments (mist inside vents). Add in all those mucus secretions to grow on and your body becomes a nice culture medium. They can also infect the urinary tract via indwelling catheters. Again, they usually replace the original infectious agent after the original antibiotics kill that one off. They thrive in patients who are chronically or severely ill and/or immunocompromised.

Hospital acquired infection can be due to many different types of bacteria. P. aeruginosa is just one of these. I'm sure the entire story isn't out yet on this poor girl's tragic death. She was very young to have died this way. The fact that there also were amputations involved lead me to believe that she had other infectious processes going on also.

http://medind.nic.in/ibi/t06/i4/ibit06i4p287.pdf

This article is technical but outlines rising carbapenem resistance. Carbapenems have been used in the past to treat serious Pseudomonas and other gram negative infections (Pseudomonads are classified as gram negative rods). The bacteria are getting smarter and are producing enzymes that break down carbapenems. This is fairly recent (last five years or so). Doctors are running out of big gun antibiotics to treat these horrible infections. The last paragraph in this article says it all:

"Antibiotic resistance is increasing at an alarming rate, leading to increased morbidity, mortality and treatment costs. A key factor in the development of antibiotic resistance is the inappropriate use of antibiotics. The medical fraternity needs to understand that antibiotics constitute a precious and finite resource. Unless conscious efforts are made to contain the menace of drug resistance, multi-drug resistant organisms, untreatable by every known antibiotic, may emerge, reversing the medical progress made by mankind and throwing us back to the pre-antibiotic era."

We are seeing organisms, mostly another gram negative called Acinetobacter baumanii, being resistant to nearly every antibiotic we test. This is another multi-drug-resistant bug hospitals and medical professionals are watching closely.

To become a long term patient in an ICU unit anywhere means you are being exposed to many resistant bacteria. If you are visiting patients in ICU units you can take these organisms out with you. Insist on handwashing by all personnel who touch your loved ones. Do NOT take the kids in to visit your loved one in these units. Don't camp out in ICU waiting rooms with your kids. People are in and out of these units all day long bringing these bugs out with them. Yes, I know, you put a couple of dabs of hand gel on your hands and you feel safe. It's still better to wash your hands thoroughly with soap and water and not eat food in hospital waiting rooms or have your kids in them. Go down to the cafeteria to eat. Wash your hands well BEFORE you eat and BEFORE you touch the food. Believe me. I see what grows on these patients from ICU units. I work with these cultures all of the time. Nursing home patients, expecially patients who were recently discharged from ICU's to go to skilled care hospitals and who are still on vents, pose the same risks. Don't take tiny kids to visit auntie/grandma/grandpa in these units if they're freshly out of ICU or if they had MRSA or other multi-drug resistant infections while in the hospital. New studies have shown that these bugs can travel around on your clothes. I'm not saying this to make you paranoid; I'm saying this stuff to make you aware that the bacteria ARE out there. Most people who die tragically like this are not famous. It just so happened that she was high profile so it made the news. People die of these types of infections in hospitals EVERY DAY.

Go and wash your hands now.

[du_grad]

23. Sorry about the duplicate posting

The computer didn't look like it posted it the first time I clicked so I went back and clicked post again. Sorry, moderators :-(.

[Arkansas Granny]

25. Thanks for the tips. You've got a lot of good info here.

[eilen]

26. One of my biggest pet peeves: People bringing toddlers on hospital visits. nt

[du_grad]

24. This is true

[applegrove]

14. Very sad.

[Haole Girl]

20. I'm very sorry to hear this

She was so young. :-(