Free Chameleon by Ken McClure Page B

bacteria of some sort in their nose and throat and on their skin. Usually it comprised a variety of harmless bugs but in a few cases people carried organisms which could cause disease in others in certain circumstances. It was naturally unwise for these members of staff to be near patients with open wounds.
     
    There were a number of possible explanations for a completely negative test and Jamieson considered them in turn. If the person was on some kind of anti-bacterial treatment then the normal bacterial flora of the body might have been destroyed. Alternatively, antiseptic creams might have been applied to the areas to be swabbed before the test but that would demand some explanation. Jamieson made a note of the two reference numbers from the result sheet and resolved to pursue the matter further when he had finished reading the paperwork. He finished going through the staff reports and changed to reading the lab report on the infecting organism.
     
    The cultural characteristics of the bug were recorded and its identity had been established beyond doubt. It was only when he saw the results of the antibiotic tests against it that he saw where the real trouble lay. The organism seemed to be immune to every known antibiotic on the standard treatment list. There was simply no way of treating such an infection. 'No wonder they died,' he said quietly.
    For bacteria to become resistant to antibiotics was nothing new. It happened all the time and, perversely, especially in hospitals. With so many drugs around it was merely a case of natural selection at work. Spontaneous mutations arose all the time in bacterial populations so when an antibiotic was injected into a patient the occasional mutant able to resist its action would survive and multiply. It would become the dominant form of the infection and if not detected and destroyed might survive long enough to affect other patients.
     
    The Pseudomonas bug that was causing all the trouble started out with the advantage of being naturally immune to many antibiotics. The acquiring of a few more through living in a hospital environment could make it a very dangerous customer indeed. Despite that, Jamieson still found the virulence of the Kerr strain surprising.
    Clive Evans put his head round the door and asked how things were going.
    'I know a bit more now than I did earlier on,' replied Jamieson.
    'Good. Can I show you where the staff restaurant is?'
    Jamieson looked at his watch and was surprised to see that it was after one o'clock. He said. 'Can I ask a couple of questions first?'
    'Of course.'
    'There are two members of the surgical team who had two successive negative results from their swab tests. Was this followed up?'
    'No, I don't think I noticed that,' confessed Evans.
    'It might be an idea to check them out.'
    'We've just done another swabbing this morning but you are right, we should have caught on to that. Who were the two?'
    'I can't give you names. They were only numbers were on the sheet you gave me. These ones.' Jamieson handed Evans a sheet of paper with the reference numbers on it. Evans put it in his pocket and said he would check. 'What was the other question?' he asked.
    'Have you had the Pseudomonas checked for the presence of Resistance Transfer Factors?'
    'No we haven't,' replied Evans. 'Dr Richardson didn't think there was much point in it. If the bug is resistant to antibiotic treatment it's resistant. It was his view that it doesn't matter much to the patient why it's resistant.' Evans saw the look on Jamieson's face and quickly added, 'Well, that's what Dr Richardson said.'
    Jamieson said flatly, 'It might help in establishing where the bug came from in the first place.'
    'I see,' said Evans sheepishly. 'I suppose we didn't consider that. We've been concentrating on trying to find synergistic action between the antibiotics available to us. Dr Richardson thought that we might be able to find some combination of antibiotics which would be effective