If it sometimes seems like the idea of antibiotic resistance, though unsettling, is more theoretical than real, please read on.
Public health officials from Nevada are reporting on a case of a woman who died in Reno in September from an incurable infection. Testing showed the superbug that had spread throughout her system could fend off 26 different antibiotics.
“It was tested against everything that’s available in the United States … and was not effective,” said Dr. Alexander Kallen, a medical officer in the Centers for Disease Control and Prevention’s division of health care quality promotion.
Although this isn’t the first time someone in the US has been infected with pan-resistant bacteria, at this point, it is not common. It is, however, alarming.
“I think this is the harbinger of future badness to come,” said Dr. James Johnson, a professor of infectious diseases medicine at the University of Minnesota and a specialist at the Minnesota VA Medical Center.
Other scientists are saying this case is yet another sign that researchers and governments need to take antibiotic resistance seriously. It was reported Thursday in Morbidity and Mortality Weekly Report, a journal published by the CDC.
The authors of the report note this case underscores the need for hospitals to ask incoming patients about foreign travel and also about whether they had recently been hospitalized elsewhere.
The case involved a woman who had spent considerable time in India, where multi-drug-resistant bacteria are more common than they are in the US. She had broken her right femur — the big bone in the thigh — while in India a couple of years back. She later developed a bone infection in her femur and her hip and was hospitalized a number of times in India in the two years that followed. Her last admission to a hospital in India was in June of last year.
The unnamed woman — described as a resident of Washoe County who was in her 70s — went into hospital in Reno for care in mid-August, where it was discovered she was infected with what is called a CRE — carbapenem-resistant enterobacteriaceae. That’s a general name to describe bacteria that commonly live in the gut that have developed resistance to the class of antibiotics called carbapenems — an important last-line of defense used when other antibiotics fail. CDC Director Dr. Tom Frieden has called CREs “nightmare bacteria” because of the danger they pose for spreading antibiotic resistance.
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In the woman’s case, the specific bacteria attacking her was called Klebsiella pneumoniae, a bug that often causes of urinary tract infections.
Testing at the hospital showed resistance to 14 drugs — all the drug options the hospital had, said Lei Chen, a senior epidemiologist with Washoe County Health District and an author of the report. “It was my first time to see a [resistance] pattern in our area,” she said.
A sample was sent to the CDC in Atlanta for further testing, which revealed that nothing available to US doctors would have cured this infection. Kallen admitted people in this field experience a sinking feeling when they’re faced with a superbug like this one.
“I think it’s concerning. We have relied for so long on just newer and newer antibiotics. But obviously the bugs can often [develop resistance] faster than we can make new ones,” he said.
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