Staff Writer
The diet of critically ill patients is a crucial but often overlooked part of care, and it could even help them avoid or get rid of dangerous antibiotic-resistant bacteria, says a surgical nutritionist at Medical College of Georgia Hospital.
Annette M. Drowlette/Staff
Surgical nutritionist Gail Cresci talks with patient Robert Griner about his nutritional needs at Medical College of Georgia Hospital.
Annette M. Drowlette/Staff
Surgical nutritionist Gail Cresci talks with patient Robert Griner about his nutritional needs at Medical College of Georgia Hospital.
Gail Cresci's work on behalf of her patients earned her the 2009 Excellence in Practice Award for Clinical Nutrition from the American Dietetic Association. She will receive the award in October during the 70,000-member group's annual meeting. Mrs. Cresci is also earning a doctorate in biochemistry and molecular biology studying bacteria in the intestine and the interaction with different chemicals.
Nutrition and installation of a feeding tube might be the last things on the mind of weary residents caring for critically ill patients, but they are critically important, she said. Making sure patients are fed through feeding tubes keeps up the level of good bacteria and other elements in the gut to help fight infection, Mrs. Cresci said. Even 48 hours without it can cause those bacteria to dwindle, she said.
"When you don't eat, especially when you don't eat the nutrients that your bacteria want, they're going to decrease in numbers and change," Mrs. Cresci said. Bad bacteria can move in.
The situation is worsened by antibiotics that can also wipe out good bacteria. The solution could be giving patients back good bacteria in the form of probiotics. Mrs. Cresci points to a small 2007 study from Australia that found that giving probiotic yogurt to renal patients with the vancomycin-resistant bug cleared it up within weeks.
"That's such a simple treatment for something so horrible," she said.
She is interested in butyrate, a chemical produced by bacteria in the intestinal tract fermenting fiber, and its anti-cancer and anti-inflammatory qualities and is pursuing doctoral work along those lines.
"Trying to have your body's own immune system be able to fight these infections instead of relying (on antibiotics) where they're down-regulated, and then you have the antibiotics that aren't effective anymore because the bacteria have gotten so smart," Mrs. Cresci said.
Critically ill patients have special nutritional needs, such as more glutamine, because rapidly dividing cells eat this up, or selenium or zinc, she said. The issue has become even more critical as rates of obesity, diabetes and heart disease rise, Mrs. Cresci said.
"The patients are not healthy when they come to us," she said.
Reach Tom Corwin at (706) 823-3213 or tom.corwin@augustachronicle.com.
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