Even if antibiotics are used according to experience, Lu Jiangbei's high fever has not subsided, and her body temperature fluctuates. She relies entirely on antipyretics and physical cooling to suppress her body temperature. This shows that the lung infection has not been controlled at all, and empirical antibiotics are ineffective.
Three days later, the results of the sputum bacterial culture came out. Yang Ping turned on the computer screen and called up the test results: MRSA, with the abbreviations of several English letters very eye-catching.
MRSA---Methicillin-resistant Staphylococcus aureus, one of the superbugs.
The so-called superbugs are resistant to almost all antibiotics due to genetic mutations. They have become invulnerable and cannot be killed by antibiotics.
Because of their extremely strong drug resistance, doctors have almost no weapons at their disposal against these bacteria, so it is very difficult to treat them.
To deal with MRSA, only vancomycin can be used.
The drug susceptibility test sheet also showed that, except for vancomycin, all other listed antibiotics were resistant.
What a careless guy, Yang Ping cursed in his heart!
The entire treatment process is extremely hard and full of twists and turns. If you make any mistake, all your efforts will be wasted.
Director Pan didn’t want to make this call, but there was no other way. Facts were facts. They were really afraid of what would come. Almost all clinicians would be frightened when encountering superbugs.
"Professor Yang---"
"I have seen the inspection report and am coming over now. Let's meet and discuss it."
After a few words of communication, Yang Ping rushed to the trauma ICU again. Since it was not in the same building, it took some time to rush back and forth.
When Yang Ping arrived, temporary ICU workers August and Robert were already standing at the door to greet him.
After swiping the card to open the door, Yang Ping went straight to the doctor's office.
At this time, the inside was already full of people, including Director Pan, the doctor in charge, Dr. Zhou, the head nurse, and several colleagues from the Department of Respiratory Medicine, the Hospital's Infectious Diseases Department, the Laboratory Department, and the Blood Transfusion Department.
The emergence of super bacteria makes everyone feel like they are facing a formidable enemy.
MRSA infection itself is not an infectious disease, but as long as there is infection with the pathogen, there is a possibility of cross-infection.
Once this kind of super bacteria spreads due to cross-infection, the consequences will be very serious.
When Yang Ping came in, everyone stood up to show courtesy, and Director Pan personally welcomed Yang Ping to his seat.
"The patient has been moved to the isolation ward. The chest X-ray was reviewed and the infection area is expanding." Director Pan sat down and was the first to speak.
The director of respiratory medicine took a sip of water: "What should we do now?"
"What else can I do? Prescribe vancomycin! Xiao Zhou, use my job number to prescribe vancomycin. Use it now."
Director Pan was scolding his mother in his heart. Of course, he was not scolding others, but scolding this bacteria. It had been a long time since he had been involved in such an unfortunate thing, and this time he was actually infected.
Vancomycin is a new type of antibiotic. It is known as the nuclear bomb among antibiotics. It will not be used unless it is a last resort. It is the last weapon for doctors to deal with infections.
The originator of antibiotics was penicillin, which at that time was called the "life-saving miracle drug".
Since the beginning of penicillin, mankind has entered the era of antibiotics. Many bacterial infections that were incurable in the pre-antibiotic era were easily cured by penicillin. Since then, many types of antibiotics have entered clinical medicine.
If bacteria are the shield, antibiotics are the spear.
There will naturally be a struggle between spears and shields. Bacteria are smart and will not sit still and wait for death. In order to survive, they will find ways to avoid the attack of antibiotics.
As drugs are used for extended periods of time, bacteria have accumulated rich experience in dealing with antibiotics. They pass this experience from generation to generation and continuously optimize it, making some antibiotics ineffective.
So-called drug-resistant bacteria have emerged. These drug-resistant bacteria can use some methods to render antibiotics ineffective and thus survive.
The principle of survival of the fittest also applies to the bacterial world. Resistant bacteria survive and reproduce, while bacteria without resistance die from antibiotics and eventually become extinct.
Methicillin-resistant Staphylococcus aureus is the leader among these drug-resistant bacteria and has won the crown of superbugs.
Against this background, scientists had to invent new weapons in order to deal with drug-resistant bacteria, so vancomycin, the "King of Antibiotics", was finally put into clinical use in 1972.
Vancomycin can be called a nuclear weapon among antibiotics. Since it was put into clinical use, it has been invincible and sterile. In the 16 years since its use, it has created an unbeatable record---not a single case of resistant strains has emerged.
It was not until 1988 that vancomycin's unbeatable golden status was broken. In 1988, the first vancomycin-resistant strain appeared. This type of bacteria was enterococci.
Since then, vancomycin has been a little unable to do its job. In 2002, the first case of vancomycin-resistant Staphylococcus aureus (VRSA) appeared. Of course, this kind of bacteria is very rare at present, but once a VRSA infection is diagnosed, it is most likely to be disastrous.
Fortunately, Lu Jiangbei was infected with MRSA, not VRSA.
Even if MRSA bacteria are enough to kill Lu Jiangbei, he is not a patient with only a lung infection. His entire body, including his limbs and trunk, is in a state of paralysis. There are fractures in many places in his pelvis and body, and he is severely injured due to excessive blood loss.
With anemia, the entire person's immune system is in a state of near collapse.
If the lung infection cannot be controlled in time, once a certain critical point is exceeded, respiratory failure will fall from the sky. In the end, he will have to slowly die with the support of ECMO.
Dr. Zhou received Director Pan's oral medical orders, temporarily left the conference table, and went to the computer to write medical orders. Once the decision was made, he did not want to waste a single minute.
"That's the only way." The director of the Department of Respiratory Medicine nodded.
In the face of this superbug, vancomycin has become the only choice. There is no controversy and no need for discussion.
"Can your blood transfusion department be more relaxed and give more blood? If the hemoglobin cannot rise, the immune system will collapse sooner or later." Director Pan was straightforward and no nonsense. Now that Yang Ping is here, the blood transfusion department is afraid and will be more cooperative. Director Pan said in a tone of voice
It’s also sharper.
Director Yuan of the Blood Transfusion Department was very embarrassed: "It's not that we don't give it, the blood station is very short of blood right now. This patient has already received more than 70 blood. It's a bit difficult to ask for a lot more blood, but we try our best."
Director Pan was very angry: "Don't always look at rules and regulations, but look at the specific situation."
"I can't help it. It's not your department that wants blood. I can't count the departments of gastroenterology, general surgery, obstetrics and gynecology. There are no departments that are urging us every day. The director of the general surgery department scolded me on the phone yesterday. It's useless to scold me.
"I can't bleed. If you can, you can draw my blood now." Director Yuan stretched out his arm.
"Old Pan, please understand each other. Professor Yang is here today. I promise to give you blood as a priority and try to meet your needs, but I really can't guarantee a sufficient amount. You have already requested more than 10 units of red blood cells.
This time you ask for 10 more units, what do you want me to do? Give 6 units for use first, and we will talk about it later."
"Six units?" Director Pan sneered, you are sending beggars away.
Indeed, Lu Jiangbei now desperately needs to continue blood transfusions. As his hemoglobin increases, his immunity will also increase. Moreover, if he undergoes surgery, a hemoglobin of more than 70 will not be enough.
"8 units!" Director Pan argued.
Director Yuan refused at all: "It's impossible. Yesterday, a patient in the general surgery department with a ruptured liver and spleen was waiting for me to donate blood."
Director Yuan is also in a dilemma. Resources are limited, and everyone is eagerly waiting for his blood. What to do, we can only strictly control it.
"Give me 10 units!" Yang Ping finally spoke.
Lu Jiangbei's current situation requires a blood transfusion. Several units of red blood cells are really not enough.
Director Yuan had just started arguing with Director Pan. He was speechless for a moment and said slowly: "Okay, 10 units!"
After the argument ended, the director of the hospital's infectious disease department rubbed his eyebrows and wanted to speak.
The Infectious Disease Department is a group of people who are hated by everyone in the hospital. Their job is to try to find loopholes in the hospital's Infectious Disease Department and make up for it in a timely manner. This kind of fault-finding work method is bound to be disliked.
"We should still investigate. We will investigate the cause of this infection. I hope it will not interfere with everyone's work. Please pay attention to washing your hands. We will focus on monitoring the trauma ICU these days." The director of the hospital's infectious disease department obviously lacked confidence and said very modestly.
.
"Yeah!" Director Pan hummed in a low voice.
---
Because of the huge change in her condition, Lu Jiangbei's mother was once again pushed to the interview room of the trauma ICU. Dr. Zhou from the ICU has talked to her several times in the past few days.
She could have entrusted the family's diagnosis and treatment activities to relatives, such as her brother or sister, but she was uneasy and felt that she was competent, so she personally acted as a family member, and her brother and sister took turns to accompany and take care of her. "When will the surgery be performed?" the middle-aged mother asked.
Yang Ping shook his head: "It's not possible to operate yet, let Dr. Zhou explain it to you."
"Lu Jiangbei has been having a high fever for the past few days and has been diagnosed with a lung infection. The bacterial culture results have come out. It is methicillin-resistant Staphylococcus aureus, which is one of the super bacteria. We have now used super antibiotics ---
Vancomycin, however, cannot guarantee that the infection can be suppressed. His life will be in danger at any time and his breathing may stop at any time. You must be mentally prepared." Dr. Zhou, as the doctor in charge, led the conversation, with Yang Ping and Director Pan sitting next to him.
"Is this a condition notification? If respiratory failure occurs, do you need to use ECMO? The cost of ECMO is very high, and the out-of-pocket cost is very large." Dr. Zhou handed over several pages of the informed consent form.
Be mentally prepared!
When the middle-aged mother heard the last few words and read a few pages of the informed consent form, her head went blank and buzzed. In the previous conversations, every time the doctor talked about life-threatening dangers, she always dismissed it and always felt that this kind of thing
Very far away from myself.
But this time was different. For some reason, she felt the pressure of death rushing towards her, like a huge stone that made her unable to breathe, because she knew that not long ago, a patient with respiratory failure passed away here, and she saw her family members with her own eyes.
Crying in the corridor.
"Originally, he was not out of danger, but now there is a new risk. Once the lung infection cannot be controlled, respiratory failure will occur, and then --- it will lead to death." Dr. Zhou continued.
The mother's eyes were dull. At this time, the word "college entrance examination" was no longer in her mind. She had completely forgotten the existence of the college entrance examination, and her entire mind was occupied by the word "death."
"Doctor, help, save him---"
After a long time, my mother squeezed out these words in a pleading tone.
"We will try our best, but many things are beyond our control," Director Pan added.
The mother was very heartbroken and nodded mechanically: "Can I go in and see the child?"
Director Pan took over: "He is now infected with super bacteria and is not suitable for visits. If you want to visit, you can visit him in the visiting corridor outside through the glass."
Sometimes it’s really hard to tell. In this situation, respiratory failure may cause death at any time. Director Pan has also been in the battlefield for a long time and has seen many life and death separations.
Under the arrangement of Director Pan, Lu Jiangbei's mother, sitting in a wheelchair, saw her son through the glass. He was lying on the hospital bed with various tubes connected to his body. Most of his upper body was covered by the brace. He could not see at all.
Unclear face.
The mother couldn't help lowering her head, covering her eyes, and began to cry loudly.
Her mind was in a mess now, filled with regretful emotions. Those auxiliary machines and those channels made her truly realize that the child might leave her.
From childhood to adulthood, she has actually been complaining and scolding her child, comparing him with other children, never really considering his feelings, and always squeezing all his space with studying and college entrance examinations. Every time the child's performance drops, it will
After being insulted by her, every time her child's grades improved, she would always say lightly that he needed to continue working hard, and it was impossible to get 211 or 985 with this kind of score.
The more she thought about it, the more guilty Lu Jiangbei's mother became. She felt that she had never really cared about her child.
If he can survive, no matter whether he can go to college or not, no matter what career he has, as long as he lives a healthy life, she will accept it. She will accept everything as long as he is good.
"Doctor, save him, no matter what, save him." Mother repeated these words.
"We will try our best. We have used vancomycin now. We will wait a few days to see the situation. If vancomycin is not effective--" Director Pan did not say any more.
