HIV and ID Observations

Over on Medscape, one of my ID heroes, John Bartlett, has a new series called, “The Medscape Awards in Infectious Diseases” and it looks like a winner.

Here’s how it works:

The Medscape Awards in Infectious Diseases is a new series that will honor the greatest achievements in the field of infectious diseases during 1980-2012. John G. Bartlett, MD, Professor of Medicine, Johns Hopkins University School of Medicine, identified 8 key categories for these infectious disease awards… Readers will be asked to select the candidate that they believe is most worthy of this title, and then Dr. Bartlett will reveal his personal choice and the reasons for that choice.

OK, I’m game — for two reasons. First, practically anything that has John’s distinctive combination of scholarliness and practicality behind it has got to be good; and second, I am a towering nerd when it comes to Infectious Diseases. I admit it.

So bring on the first category — “Bacterium”.

The question is, “What do you believe was the most important discovery of a new bacterium during the time period 1980-2012?” Here are the choices, and my thoughts about each one:

• 1980: Borrelia burgdorferi (Lyme disease) — has spawned an entire parallel universe deftly described here.
• 1982: Escherichia coli O157:H7 (hemorrhagic colitis) — posits the eternal question, can a person really learn to prefer a hamburger well-done? Here’s my opinion.
• 1983: Helicobacter pylori (peptic ulcer disease) — one of the true oddities of helicobacter is that ID doctors know nothing about it; it’s like asking an MD about teeth.
• 1986: Chlamydia pneumoniae (atypical pneumonia) — also the cause of coronary artery disease … NOT.
• 1999: Bartonella henselae (cat-scratch disease) — this is my first Ted Nugent citation on this blog.
• 2000: Tropheryma whipplei (Whipple disease) — number of cases most ID doctors personally have diagnosed = zero. Which equals the number of Whipple Procedures they have done, too.
• 2000: Methicillin-resistant Staphylococcus aureus (USA 300 strain) — USA 300 sounds like a motor race, and not surprisingly, it actually is one too.
• 2000: Clostridium difficile NAP-1 strain (C difficile epidemic) — probably the best reason out there to avoid unnecessary antibiotics; I’d be shocked if we’re still using antibiotics as our primary treatment for C diff in 5 years.
• If not listed here, tell us about your choice — I would consider Klebsiella pneumoniae carbapenemase bacteria (KPCs), since they’re a glimpse of a post-antibiotic era, or Streptococcus gallolyticus, because it’s the new name of Strep bovis that I can never remember, or if we’re talking new names in the past 20 years, Stenotrophomonas maltophilia, since it’s such a wonderful mouthful to say.

So my vote?

MRSA all the way.