The problem with the natural Staph population is that for the past ten years or so it has morphed into a bacterial population that is increasingly multi-drug resistant, or MRSA, says Dr. Rupp. VRE occurs naturally in the gastrointestinal tract and C. diff resides in the gut, but it has some special properties.


"VRE is a little bit different of an organism in that it can produce spores which are very environmentally hearty," says Dr. Rupp. "Most bacteria when you put them on a surface they eventually dry-out and die. But C. diff can remain viable for long periods of time. We're talking months if not years, and that can be particularly problematic if you don't go in and use different techniques to try and decontaminate the environment."

Compounding the problem is the fact that the organism has become far more virulent in recent years, forming more spores and more toxins than ever before.

"It's completely unknown what kind of evolutionary pressures are making it do this," states Dr. Rupp. "We do know that it's got some mutations in some regulatory domains in the genome that is responsible for this change of producing more toxins and more spores, but we don't understand why that is."

All of these bacteria can be "shed" onto touch surfaces or the near patient environment either by the patients themselves or health care workers, thereby increasing the chances that someone will pick up the organism. Just because someone becomes colonized does not necessarily mean they will become adversely affected, however. Normally, the body has immuno checks and balances that keep infection at bay, but for individuals with compromised immunity, or who have undergone surgery or dialysis or those who have received intensive antibiotic treatments in the past, these bacteria can run wild and cause potentially life-threatening symptoms.

Symptoms of skin infection like abscesses can be a good indication that MRSA colonization has become a serious issue. VRE can lead to urinary tract infections, more serious bloodstream and heart valve infections and meningitis. C. diff produces toxins that can lead to inflammation and infection of the colon. The issue that has epidemiologists like Dr. Rupp concerned is that even people without risk factors are getting infected and the trumped-up bacteria are increasingly moving out into the community, no longer satisfied with being isolated in health-care environments.

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