Gut Feelings about Hard Work and Human Health

Advancing knowledge about good and bad bacteria

Dr. Michelle Alfa grew up poor on a farm in southwestern Manitoba, but far from dismissing those days, she looks to them for inspiration.

“Dad was amazing. He instilled in me and my siblings an amazing work ethic,” recalls Dr. Alfa, Principal Investigator, Infectious Diseases, Canadian Centre for Agri-Food Research in Health and Medicine. “He wasn’t wealthy enough to have an actual silo to put the grain in. To protect the grain, we had to actually clear dirt and put down a tarp, and then put bales around it up to a height, so that as he brought in the grain, we could pour it into this receptacle and then he would cover it with plastic.”

“You know you always have to get your work done before you go for treats.”

It was back-breaking work, but Dr. Alfa remembers the pride of being out there as a family, everybody doing their bit to get the job done. She recalls one time when her younger sister asked their dad if they could get an ice cream cone. “My dad said, ‘As long as we get it all finished before it’s dark. You know you always have to get your work done before you go for treats.’ That was a work ethic that I think has been with me forever.”

That work ethic – and her commitment to teamwork – have indeed stuck with Dr. Alfa her whole life. It explains the success she is achieving in her research on hospital-acquired infections; reducing infections from medical devices; and the role of the gut microbiome in the health of the elderly. All three research streams connect to Dr. Alfa’s rich understanding of bacteria.

As far as her work on gut health in the elderly goes, the take-away message is simple. Past the age of 60, the good bacteria in the colon need to be nourished with “prebiotics” to retain their effectiveness. Feed your bacteria “some raw vegetables because they’ll love it,” enthuses Dr. Alfa. “Ten to 15% of all of our energy comes from bacteria products. It’s important to keep our microbiomes happy because when they’re happy and eating the roughage and the things that we can’t digest, it actually helps our gut. The cells that line the inside of our gut, they get their energy directly from the bacteria end products. If they don’t get those right end products from the bacteria, the cells in the gut die off. You can see that as you get older, and if you have fewer raw vegetables and you’re eating more and more processed food that’s been cooked and maybe it doesn’t have the nutrients in it, you can see that your gut is going to deteriorate. That has been shown scientifically.”

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While Dr. Alfa’s research has expanded the dialogue on the good bacteria that live in our bodies with a particular focus on the elderly, she has also advanced the understanding of less-likable bacteria that live inside every hospital and that can make patients more ill.

An example would be when a patient is admitted to a room where the previous patient had Clostridium difficile (C.difficile) or Methicillin-resistant Staphylococcus aureus (MRSA). Despite strict protocols for cleaning and disinfecting, “there’s evidence to show that if you are admitted to a room that was occupied by somebody who had those infections, your risk of getting the same infection is actually higher than if you were admitted to a room occupied by somebody who didn’t have them. That got my interest in terms of the environmental role because we should be able to prevent those infections,” she says. Reducing the incidence of C.difficile is particularly important as that bug tends to lengthen patients’ hospital stays and can be fatal in some cases.

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While hospitals the world over deal with this issue, Dr. Alfa is extremely grateful to administration at St. Boniface Hospital for allowing her to conduct clinical studies onsite to arrive at solutions to this global challenge.

“Our housekeeping staff has been fantastic,” says Dr. Alfa. “When we did our study on improving the agent that was used for cleaning hospital surfaces, and we showed there was a reduction of hospital-acquired infections, the Hospital adopted that. I have to say I’m very proud of the support we’ve received from the Hospital and the fact that our research has made a difference.”

Dr. Alfa and her team have also conducted research into the proper disinfection and sterilization of re-usable medical devices, like scopes. And here, too, they have made important progress that will affect hospital protocols, equipment manufacturing, and national guidelines.

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Dr. Alfa has been conducting her research at St. Boniface Hospital for over a quarter of a century and you could say that her unbridled enthusiasm for the Hospital, the Albrechtsen Research Centre, and the St. Boniface Hospital Foundation is, well, infectious.

“I’m a Manitoban in my heart. Manitoba is home. It always has been. I’m always really proud of the Research Centre, the St. Boniface Hospital, the Foundation, and the fact that we’re getting support from people like Paul Albrechtsen, and support for our clinical studies from industries in Manitoba,” says Dr. Alfa. “It shows you that home can be a wonderful environment to work in, and we can make new discoveries that have an impact on improving health and healthcare.”

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