Nurse! Yoplait! Stat!
How ‘probiotics’ like yogurt might slow the spread of superbugs
It sounds ludicrous, but your next surgery could come with a side of yogurt. A new study published in the British journal The Annals of the Royal College of Surgeons is advocating that doctors dip their hands in yogurt after scrubbing up. The sight of doctors vigorously washing their hands before surgery is ubiquitous in both pop culture and reality, but Professor Mark Spigelman of the University College London and the Hebrew University in Jerusalem believes that all that scrubbing might be allowing bacterial superbugs to thrive in hospitals.
Instead of antibiotics, he is calling for a probiotic approach — using good bacteria to keep bad bacteria at bay. The problem Spigelman is looking to solve is bacterial- resistant superbugs that thrive in hospitals but are rarely found in the outside world. Most often they are referred to as MRSA, which stands for methicillin- resistant Staphylococcus Aureus but has come to be used as the catchall term for organisms that are resistant to commonly used antibiotics.
“ How is it that when you get into the community, there’s very little MRSA, but it’s been in hospitals for 45 years?” he asks. “ So what causes them? The simple answer is antibiotics.
“ And the second thing is, what spreads them? It’s people. These things don’t float around in the air very much. They’ve got to be spread by something.” Spigelman believes that all that hand scrubbing might be creating a place for bad bacteria to thrive.
“ I’m a surgeon, I go to an operating theatre. I might scrub my hands eight, nine, 10 times in a day. There’s nothing wrong with that scrubbing. The first time, I may even kill a few MRSA bugs that I’ve got around me.
“ But then by the tenth time — or in fact, the second or third time, if I’m scrubbing properly — there’s nothing left,” he says. “ So what I’m killing are the normal, harmless, skin bacteria. And we know that bacteria don’t live in mixed neighbourhoods.
“In other words, they don’t grow next to each other. They have colonies. Generally speaking, it’s colonies living in isolated patches. They don’t grow next to each other, as they attack each other.
“ If you’re skin is covered in harmless skin bacteria, the chances of MRSA or other multidrug resistant- bugs surviving are much less.”
Which is where the yogurt comes in.
Spigelman would like to see trials where, after an operation, a surgeon covers his hands with harmless bacteria — the kind that are present in yogurt cultures and might stop the spread of resistant bugs.
“ I expect to be vigorously attacked and pilloried by my colleagues and in the press,” says the 65- year- old professor. Maybe, but he has one supporter on this side of the pond.
“ There are a lot of people who are talking about ways to rethink how we deal with bacteria and antibiotics,” says Dr. Michael Gardam, director of infection prevention and control at the University Health Network in Toronto.
“ But there is such a thing as good bacteria, and right now antibacterial soap does tend to take a kill- them- all approach,” he says.
“ So looking at ways to replenish the flora on skin could be something that offers a survival advantage. . . Adding good bacteria — like the probiotic that is suggested, yogurt — might be something worth giving some serious thought.” Which is exactly what Spigelman is advocating.
“ The concepts of sterility and antisepsis, like antibiotics, I think we need them,” he says. “ They save millions of lives, we can’t do without them. But we have to decide how to use them.
“ The idea of antisepsis was developed by Lister about 150 years ago. The bacteria have learned a bit since then. We haven’t.”