A Nurse with a Nose for Healing
Section titled “A Nurse with a Nose for Healing”Nurse Lasky didn't stand out among the nurses in the nursery at New York Hospital. She came to work on time each day, donned a fresh set of scrubs, washed up carefully, fed and nurtured the newborns in her care, and checked their vital signs.
In fact, she washed up extra carefully that spring of 1958. A deadly strain of Staphylococcus aureus called 80/81 had spread through hospitals in the Eastern US, killing babies. No antibiotic touched it. Sterilizing entire nurseries, improving gown and gloving techniques — nothing worked.
Staph 80/81 was a specific bacterial infection that not only resisted antibiotics but, unlike other strains of Staphylococcus aureus, had a disturbing tendency to invade and kill the very old and the very young. About one in four of us carry staph bacteria in our noses, but the staph we carry is smart enough to live and let live. Staph 80/81 displayed no such restraint.
Infectious disease experts studied every aspect of the outbreak, to the point of testing every healthy baby in the nursery and every nurse who worked there. As time went on, a pattern emerged: none of nurse Lasky's newborns were getting sick. The experts zeroed in on Nurse Lasky. She was a staph carrier, but of a strain they knew as 502A. Testing showed the babies in her care each also carried staph 502A in their noses. (This did not indicate a breach of procedure by nurse Lasky. A nursery is not an operating suite.) 502A was known for benign behavior, taking up residence on a human but not causing illness. In fact, the benign staph seemed to prevent the dangerous staph from getting a toehold.
Pediatrician Henry Shinefield recognized that nurse Lasky was a kind of Typhoid Mary in reverse. Instead of spreading disease, she was preventing it. Shinefield and other physicians across the country began to inoculate babies with 502A. The death rate fell, and the epidemic came to an end.
This story comes from the book Good Germs, Bad Germs by Jessica Snyder Sachs. Sach argues that we humans are not isolated individuals. Instead we share a community of organisms that make up the total human ecosystem. We live, and have lived forever, in cooperation with multitudes of microorganisms. Bacteria inhabit our stomach, our skin, all our orifices, and they are mostly pretty benign. Occasional battles erupt, as when pneumonia or food poisoning overwhelms our defenses, but much of the time we coexist peacefully with our invisible cohabitants.
Born into a World of Germs
Section titled “Born into a World of Germs”How do we acquire our population of organisms?
Section titled “How do we acquire our population of organisms?”Mother is pregnant with her child. In the last months of pregnancy, her vaginal cells begin to secrete more glycogen. This nutrient feeds the lactobacillus in her vagina, which increase in number. Around the same time, bifidobacteria move into the milk ducts in her breasts, taking up residence there. These same bifidobacter are populous in the intestine, protecting us from harmful intestinal bacteria and reducing our tendency to allergy.
As labor begins, the baby is sealed inside the amniotic sac, sterile, warm, and a bacterium's dream home. The amniotic sac breaks and mother pushes the baby's head through the lactobacillus soup in her vagina. Most babies are born face down, so baby's mouth next passes by mother's anus, picking up her beneficial Escherichia coli and other intestinal flora. She puts baby to her breast, and baby sucks in billions of bifidobacter, which promote the production of protective antibodies in baby's blood. If this seems a little too earthy, consider this fact: in third-world countries, babies denied the breast and given the bottle are six times more likely to die of infectious disease.
A newborn baby's skin is covered with the cheesy vernix, which picks up the lactobacillus from mother's vagina. Lactobacillus does not survive in our oxygen-rich atmosphere, so it dies leaving a residue of hydrogen peroxide and lactic acid. This residue, in combination with the anti-bacterial enzymes in the vernix, repels harmful staph such as 80/81. Within hours, beneficial staph, such as Staphylococcus epidermidis, begin to occupy this ecological niche, preventing undesirable neighbors from moving in. Mother's microorganisms travel to every crevice and corner of her baby's body.
Bacteria to Battle Bacteria
Section titled “Bacteria to Battle Bacteria”Bacteria are constantly competing with each other and have been doing so for eons. Think about carrot peelings in your compost heap. As the bacteria in the heap change it from recognizable orange-colored parings to rich, black humus, they fight each other hard for their place in the food chain. The losers in that battle went extinct long ago.
Today, investigators study this bacterial warfare as intently as the Pentagon studies human wars.
One typical study involved bacterial vaginosis, an irritating vaginal condition caused by an imbalance of bacteria. We know that the healthy vagina hosts Lactobacillus acidophilus, but sometimes other bacteria displace it and cause discomfort and discharge. One researcher collected Lactobacillus from many different women. The winners of this bacterial Olympics, Lactobacillus rhamnosus G-1 and Lactobacillus fermentum RC-14 proved superior at getting through the human GI tract, colonizing a suffering vagina, resisting spermicides, and relieving symptoms. These bacteria are available under the brand name Fem-Dophilus.
Similarly, the Culturelle brand of Lactobacillus acidophilus and the Florastor brand of Saccharomyces boulardii are for many people the most effective treatment for antibiotic-associated diarrhea and other intestinal disorders.
To Learn More…
Section titled “To Learn More…”Here's the take-home message. You are a minority group. There is just one of you compared with the 700 trillion bacteria in your GI tract and on your surface. Wait, you say, let's count all my cells. No good, you've only got about 70 trillion, you're still outnumbered.
If you find this topic as exciting as I do, check out Good Germs, Bad Germs by Jessica Snyder Sachs. What you'll learn is how much modern illness, some of it quite disabling, results from our separation from bacteria and other microorganisms in our environment. We evolved in company with microorganisms and domestic animals, and some of us suffer when removed from this customary environment. You'll learn how antibiotics are but one way to treat infection, and how scientists are learning to harness certain kinds of bacteria to improve our health. Best of all, you'll learn a little bit more about how to live in harmony with your billions of symbiotic neighbors.
New Year's Resolutions
Section titled “New Year's Resolutions”Think twice about your microscopic roommates. Wondering what to have for lunch? You are not feeding only yourself, but about 1000 kinds of bacteria and fungi in your colon, and they are a lot pickier eaters than you are.
First, go for high-fiber foods such as fruits, veggies, and grains. Your harmful bacteria are fine with junk food, but your protective residents thrive on fiber. Without it, for example, they make less butyric acid, which makes you more prone to develop colon cancer.
Second, remember fermented foods. We humans have learned over the millennia to cultivate beneficial bacteria in our food — such as yogurt, cheese, kefir, sauerkraut, and tempeh. Not all fermented products contain helpful bacteria. (Grain alcohol? No way!). But you can take advantage of the foods mentioned above when appropriate.
Finally, as much as possible, buy high quality food. Of everything we spend money on, the most important is food. Good quality fruit, vegetables, and meat cost more than pasta, bread, and lowest-price produce. Buying better quality food will save more in medical bills than it will cost and you will enjoy a higher quality of life.
Coming Next Month — This month I described your microscopic roommates. Next month, I will explore how prescription antibiotics affect your 700 trillion best friends.