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  • Flesh-eating bacteria sounds like something out of a horror movie, but in fact, it’s

  • very real.

  • And while rare, cases of it do occur all over the world each year.

  • So let’s confront this villain head-on and flesh it out.

  • Thank you for coming.

  • Hi, my name is Isaac Chiu.

  • I'm an assistant professor at Harvard Medical School in the Department of Immunology.

  • I'm very interested in understanding how pathogens interact with the immune system and in this

  • case, in highly invasive infections such as flesh-eating disease.

  • Flesh-eating bacteria is more commonly known as a necrotizing infection.

  • This cell death of the body’s soft tissue is called necrotizing fasciitis, and you can

  • get the types of bacteria that cause it in a few different ways.

  • So you could get necrotizing fasciitis from a bacteria that came in from an insect bite

  • or from a wound.

  • Maybe you had an opening in your skin and you stepped in brackish water.

  • So there are many ways which bacteria can get in.

  • And one of the main types of those bacteria that causes this disease is from the same

  • family as a common infection we all know and have maybe even hadstrep.

  • Six hundred million people a year get strep throat, but that same pathogen can also in rare cases

  • cause necrotizing fasciitis, but it's the same pathogen.

  • The leading cause is streptococcus pyogenes, but it can also be caused by both gram-positive

  • and gram-negative types of bacteria, including staph aureus and vibrio.

  • And some actually are polymicrobial so there are several bacterias together that form these

  • necrotizing invasions.

  • So a big question is how does the bacteria become aggressive and dangerous, causing this

  • invasive type of soft tissue infection?

  • When it gets into that person in that situation, that its tissue environment sends

  • a signal to that bacteria that makes it switch on genes that are making it more virulent?

  • Is it that individual that's more susceptible to infection and that's why it's become necrotizing

  • fasciitis?

  • These are important questions.

  • And while necrotizing fasciitis is still rare, fewer than about one in 100,000 adults will contract

  • it, certain people are more susceptible to it.

  • Some risk factors include diabetes and compromised immune systems.

  • And with a mortality rate of up to about 30% in the U.S. and higher in developing nations, it's a dangerous

  • disease no matter where you live. Not to be alarmist, but I think it's definitely

  • important to watch for symptoms of infection generally to get that treated.

  • But it's very, very rare.

  • When it does infect the body, it can spread quite rapidly, invading the deeper tissues.

  • This happens when blood flow becomes blocked, destroying the soft tissue.

  • It can occur in our limbs and groin areas, and that’s how it gets its name flesh eating.

  • One of the major characteristic of flesh-eating disease is pain.

  • So pain out of porportion with other clinical manifestations

  • This could be a sign of potential necrotizing fasciitis.

  • Once this bacteria makes its way down to the deep tissues, you may not see the superficial signs

  • you’d see with a normal infection, such as redness or swelling.

  • But you would experience an extreme amount of pain.

  • Thispain out of proportionis a red flag for a possible flesh-eating disease.

  • One of the ways unfortunately to treat this disease

  • is to surgically remove the tissue or even to amputate the limb to prevent the bacteria

  • from getting further than it can go, as well as IV antibiotics.

  • So I think one of the points is that it's hard to treat because it's so aggressive.

  • Potentially if you treat it earlier on with antibiotics or surgical removal, their survival

  • rate will be better.

  • And normally, an infected site would be full of white blood cells like neutrophils, which

  • help trigger inflammation and send a signal that something is wrong.

  • Neutrophils are kind of the white blood cell army.

  • They're mobilized during infection.

  • They're circulating in our blood and they hone into the tissues as soon as there's infection,

  • but they're not able to get to the necrotizing fasciitis lesions very efficiently and they're

  • silenced by the bacteria as well through toxins.

  • If you look inside a necrotizing fasciitis tissue, you don't see that many immune cells.

  • That's one of the contributing factors because the bacteria has found a way to evade the

  • immune system.

  • But there is hope on the horizon, including treatments that can block the bacteria from

  • invading as efficiently and even the use of a common cosmetic treatment.

  • So we have found, for example, by using botulinum toxins or Botox, you can silence the nerves

  • from releasing these anti-immune molecules called CGRP.

  • So this is effective because we found that the nerves block neutrophils, the immune cells

  • that are really important for fighting infections.

  • So by blocking that with Botox, neutrophils come in to fight the bacteria at that site.

  • So these are areas we're really excited about pursuing to slow down this bacterial

  • spread during necrotizing invasion.

  • While flesh-eating bacteria and infection are rare, it’s important to know the signs

  • and seek medical attention if youre concerned.

  • I think the point is that you just should

  • see a doctor if you have, like, any infections... period.

  • So the key is to go early and get it treated.

Flesh-eating bacteria sounds like something out of a horror movie, but in fact, it’s

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食肉菌是真實存在的,它是如何工作的? (Flesh-Eating Bacteria Is Real and This Is How It Works)

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    林宜悉 發佈於 2021 年 01 月 14 日
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