Tuesday, December 29, 2009

Can CFers be Killing Too Many Bugs???

I'm constantly pleading with parents of CF children to not put their kids in a bubble. Not only does it end with the child being socially awkward, but it can also cause the child's immune system to be weakened. I have often pointed to studies that site that it is actually good for children to get sick in order to build up their immunities. I'd be much better to have a nasty cold as a kid with nice pink lungs than to get a nasty cold that you can't fight off with old and damaged lungs, like me.

I was given free reign as a kid and was not held back at all. In fact, I remember my mom encouraging me to play with kids who had chicken pox so I could get them out if the way (I never did get those)! Bottom line: Let your kids be kids. Kids like to get dirty. They like to play with other messy snotty nosed kids. They like to roll around in the dirt. Hopefully, by the time they get to be an old man like me, they'll be immune to every cold, flu, or ____ bug out there!

I also wanted to share an interesting article that falls along these same lines. I know a lot of parents out there who are disinfectant freaks. Now, I'm not saying to totally hold the hand sanitizer and whatever you clean your house with, but maybe you'll want to back off a bit after reading this article.

ScienceDaily (Dec. 27, 2009)Using disinfectants could cause bacteria to become resistant to antibiotics as well as the disinfectant itself, according to research published in the January issue of Microbiology. The findings could have important implications for how the spread of infection is managed in hospital settings.

Researchers from the National University of Ireland in Galway found that by adding increasing amounts of disinfectant to laboratory cultures ofPseudomonas aeruginosa, the bacteria could adapt to survive not only the disinfectant but also ciprofloxacin -- a commonly-prescribed antibiotic -- even without being exposed to it. The researchers showed that the bacteria had adapted to more efficiently pump out antimicrobial agents (disinfectant and antibiotic) from the bacterial cell. The adapted bacteria also had a mutation in their DNA that allowed them to resist ciprofloxacin-type antibiotics specifically.

P. aeruginosa is an opportunistic bacterium that can cause a wide range of infections in people with weak immune systems and those with diseases such as cystic fibrosis (CF) and diabetes. P. aeruginosa is an important cause of hospital-acquired infections. Disinfectants are used to kill bacteria on surfaces to prevent their spread. If the bacteria manage to survive and go on to infect patients, antibiotics are used to treat them. Bacteria that can resist both these control points may be a serious threat to hospital patients.

Importantly, the study showed that when very small non-lethal amounts of disinfectant were added to the bacteria in culture, the adapted bacteria were more likely to survive compared to the non-adapted bacteria. Dr. Gerard Fleming, who led the study, said, "In principle this means that residue from incorrectly diluted disinfectants left on hospital surfaces could promote the growth of antibiotic-resistant bacteria. What is more worrying is that bacteria seem to be able to adapt to resist antibiotics without even being exposed to them."

Dr. Fleming also stressed the importance of studying the environmental factors that might promote antibiotic resistance. "We need to investigate the effects of using more than one type of disinfectant on promoting antibiotic-resistant strains. This will increase the effectiveness of both our first and second lines of defence against hospital-acquired infections," he said.

Keep in mind, this is coming from a guy who washed his hands maybe once a week and just started cleaning his nebs consistently earlier this year, so by no means am I the "clean police". So although I wouldn't advocate using my extreme of "paying pretty much no attention at all to clean vs not clean"; I would encourage you to balance life with your level of spotlessness :)

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Interesting article!

I def stick by being as clean as possible though... I never believed any of it until I started sanitizing my nebs once a week and becoming an anal hand washer earlier this year. Since then I have only needed ONE course of oral antibiotics (in 8 months). So something must be working! (or pure coincidence...)

My sister also learned in her college course that you actually kill the healthy bacteria off your hands when you use antibacterial too... so I guess that is something to consider as well.
Very Interesting article. My daughter who's 2 fights off most of what she acquires through playing with cousins or friends well. I do agree that we should not shelter our kids with cf. although it is hard not to run when you hear a nasty cough...I try to be pretty clean, cleaning her nebs before each use and washing her hands frequently. But she's two and gets into everything so I just do what I can.

love your blog by the way: just followed you...check mine out
I have to agree with Krista it's hard not to run the other way when you hear a bad cough.. with my oldest always being in a public school she always brough home germs and not always did my youngest get sick. We seem to get sick more from Late August to like April at the lastest. My youngest is in dance and goes to school plays outside and with friends. I let her be normal. I guess in some ways we are lucky for her being dx @ 9 months old cause most of things she does is "normal" to her.
*Steps on soapbox for a second* Ronnie, dude, just fyi: sterilizing nebs (by boiling them for 10 minutes) is NOT going to breed super bugs -- no antimicrobial products are used. ALWAYS sterilize your nebs THOROUGHLY. You can actually give yourself back an infection by breathing in the junk growing in their, not to mention mold. Ewww. *steps down*

You're 100% right about sanitizer. I use it only in a pinch. Washing your hands in warm water for 20 seconds (without antibacterial soap -- regular soap is perfectly sufficient and doesn't breed resistance) is the best and ONLY way to protect yourself against many forms of viruses and bacteria. MRSA and C-Diff aren't normally killed by purrell, by the way.

But I agree, I was never kept in a bubble. I had chicken pox (twice!) and plenty of colds and even a flu once or twice growing up. It's not that my parents pushed me into getting sick ("hey, your friend has a cold, why not share a juice box with her?" lol), but they didn't take me out of school or soccer league or anything else. When my CF doc told me at 13 that I should stop doing competitive horseback riding b/c there might be bacteria in the barns, my mother jumped in before I could say anything and explained that I would not only keep riding if I wanted to, but would also continue to do barn chores and everything else that came along with horse ownership. And I never did catch the bacterias he was worried about, but I sure had a ton of fun and got lots of brilliant exercise while learning responsibility. Bottom line: kids with CF are just that, kids. Thanks for the reminder not to waste a precious time in our lives.
1 reply · active less than 1 minute ago
Thanks for the comment Piper.

I was afraid that my last paragraph may be taken the wrong way :) I am in NO WAY advocating not to sterilize your nebs. I wash and sterilize mine faithfully. My point was that my extreme of being totally negligent while growing up isn't the way to go either and we need to strive to find a balance. I'm concerned for the parents who insist on keeping their kids inside the house or follow them around with a bottle of hand sanitizer.

As always though, your comments are very thought out and insightful...THANKS!!!
ctalbott0609's avatar

ctalbott0609 · 796 weeks ago

Ronnie & Piper...thank you both so much! As a new mom to a child with CF, I'm constantly being bombarded by people telling me that I need to clean and sterilize everything! I've turned into an honest jumble of nerves, and my inner neat freak is developing a case of PTSD! I've actually switched every type of cleaning agent in my house to one with Anti-Bacterial additives! Sparing you the long story though, I'm very glad to know that when I don't have the energy to wipe down every surface with a Chlorox Wipe, that I'm not being a bad mom, or risking my daughter's health. It's even more refreshing to know that when I find her chewing on one of her brother's hot wheels cars (that has been through everything on God's Earth) that I don't need to have a full on panic attack, and spend the next week freaking out that she just caught something. Point being...thank you for posting this! It's nice to know that I can relax a little!
Going to add my scientist opinion here. Purell works because it contains at least 60% ethyl alcohol (the kind you can drink) + water. The combination of the two denatures proteins (breaks them apart), which is what all bacteria are made of. Hand sanitizers with at least 60% alcohol content have been shown to be effective against most bacteria and viruses, including MRSA, VRE, and H1N1. Their ineffectiveness against C-Diff is because C-Diff forms spores, which are hard encasements that alcohol can't penetrate. (Bleach is the catch-all disinfectant of choice for pretty much any microbe, including C-Diff.) C-Diff didn't develop resistance to hand sanitizers/alcohol; it's resistance is an innate characteristic of this bacteria when it is in its spore form.

Another important point. Using plain regular soap might remove dirt/oil from your skin, but it is not antimicrobial because it doesn't contain detergents (which also denature proteins). It's probably a little bit chemistry-heavy for the layman, but soaps and detergents are quite different in their chemical structure and thus how they clean your hands--soaps encapsulate grime/grease/dirt allowing it to be rinsed away; detergents chemically break apart proteins.

On the other hand, the notion that antibacterial soaps can facilitate bacterial resistance is entirely with merit because they typically contain a broad spectrum topical antibiotic (usually triclosan) which can eventually selectively kill some microbes, but not others (similar to how penicillin used to kill most bacteria, but now many have developed resistance to it). The idea of creating "superbugs" by overuse of antimicrobial products occurs when they contain an antimicrobial compound that is not strong enough to totally kill ALL microbes, leaving resistant ones behind (survival of the fittest); instructions for use aren't followed (such as the how long to leave a household cleaner on your kitchen counter before wiping it up); or they are diluted too much.

As an adult, I clean and sterilize religiously--be it my hands, my kitchen sink, my toilet or my nebulizers. I'm a fan of bleach for my household cleaning and nebulizers because it kills everything and use hand sanitizer on my hands. I work in a university environment using shared equipment with many un-hygienic, snotty-nosed college students and have been fortunate enough to ward off most of the bugs that have been "going around" with a consistent regiment of hand sanitizer and chlorox wipes.
2 replies · active 795 weeks ago
I am literally a smarter person after reading your comment!!!! :)
Bleach doesnt kill mycobacterium in shower heads though.... at least all thats what my research said for an assignment I had to do. But I am a fan of bleach regardless.
ctalbott0609's avatar

ctalbott0609 · 796 weeks ago

Wow, that really sheds some light on things :) Thank you for posting!
Have any of you considered what chemicals in your cleaning agents do to the lungs? Bleach is TERRIBLE for the lungs. I live in a bleach free home, and we use chemical free cleaners. I believe a lot of the chemicals in cleaning products and our food is incredibly detrimental to our bodies, and even more so if CF is involved. It is getting easier and cheaper to find chemical free products for your home that still do a great job without the harmful effects caused by most traditional products. I would encourage you all to look into it, especially if you have a loved one with CF.
**Stepping off my (chemical-free) soapbox** :D

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