A recent hospital case in Spain shows antibiotics can sometimes migrate from the bowels to the lungs.
It's rare to find a case study where an infectious disease is spread in a clear-cut way.
There is a case in Spain. A patient was admitted to an intensive care unit after a seizure. They were kept alive by machines for 39 days while doctors used antibiotics.
It was suspected that the patient had accidentally breathed in food, saliva, or vomit after showing evidence of a common infections in the lungs, urinary tract, andgut.
Doctors treated the patient with meropenem after he developed a urinary tract infection. Aeruginosa was found in the patient's gut for the first time after this treatment.
The population was resistant to meropenem and was moving around. The patient's lungs were at risk of deadly pneumonia due to the resistance in the gut.
The patient's immune system kicked in and they were released after a month in the hospital. It might have been worse.
Culture screening of blood samples did not show evidence of a P. aeruginosa infection. Doctors might not have known how sick a patient was if they hadn't been careful.
Researchers found that the infections likely started in the gut three weeks before the visit to the intensive care unit.
By day 24 of the stay in the intensive care unit, the patient's lung infections had taken up residency.
The authors say there is "strong evidence of gut to lung transmission" and that it could be back again.
It's important not to generalize from a single case study, but the patient in Spain provides a unique opportunity to track how an infectious disease might evolve and spread in real-time.
If a gut infection can migrate to the lungs and carry antibiotic resistance along with it, that could be an important avenue for doctors to look at.
Both places have the same strains of gut colonization that precede lung infections. Both lines of evidence show that the infections in the bowels can be used as a source ofbacteria.
The authors say that resistance was driven by the spread of independent lineages in the gut and lung that were adapted to local differences in antibiotic concentration.
It has been shown that when populations ofbacteria migrate in the body, their adaptation to antibiotics can be accelerated.
In Spain, a patient showed P aeruginosa in their gut after starting a treatment. The authors suggest that antibiotic treatment may have helped facilitate this gut-to-lung transmission.
The authors concluded that preventing gut colonization or gut-to-lung transmission may be an effective strategy for preventing Pseudomonas infections in critically ill patients.
The study was published in a scientific journal.
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