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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.

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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.

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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.

The superbugs are growing in number and strength. Hyacinth Empinado/STAT

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.

Doctors and scientists who track the spread of antibiotic resistance — the rapidly proliferating swarm superbugs — see this case as a big red flag.

“If we’re waiting for some sort of major signal that we need to attack this internationally, we need an aggressive program, both domestically and internationally to attack this problem, here’s one more signal that we need to do that,” said Lance Price, who heads the Antibiotic Resistance Action Center at George Washington University.

There is international recognition of the threat, which an expert report published last year warned could kill 10 million a year by 2050 if left unchecked. In September, the UN General Assembly held a high-level meeting on antibiotic resistance, only the fourth time the body had addressed a health issue.

The woman in Nevada was cared for in isolation; the staff who treated her used infection control precautions to prevent spread of the superbug in the hospital. Chen and Randall Todd, a health department colleague, told STAT testing was done to look for additional infections, but so far none have been detected.

Johnson said it’s likely, though, that other people in the US are carrying similar bacteria in their guts and could become sick at some point. “It’s possible that this is the only person in the US and she had the bad luck to go to India, pick up the bad bug, come back and here it is, we found her and now that she’s dead, it’s gone from the US. That is highly improbable,” he said.

“People have asked me many times ‘How scared should we be?’ … ‘How close are we to the edge of the cliff?’ And I tell them: We’re already falling off the cliff,” Johnson said. “It’s happening. It’s just happening — so far — on a relatively small scale and mostly far away from us. People that we don’t see … so it doesn’t have the same emotional impact.’’

  • I think I hate spell “in-correct”. LOL stuck should have been *sick. And I do not remember exactly what I had intended but, advise was not it. 🙂 *Accept, probably.

  • The lies this article and the medical system tell are what are looking people, rather than the super bugs which they have created by the overuse of synthetic antibiotics. Natural antibiotics such as grapefruit extract and colloidal silver among others would have liked this bacteria and saved this woman’s life.

    • My phone changed my words apparently. Looking should have been killing and liked should be killed. Sorry about that.

    • Yes i agree it amazes me that the people can be smarter than doctors that go to schools 8+ years and spend thousands of dollars to become stupid on the topic… +1 for being smarter than the doctor. I read they cured ebola with it long after i have been a fan

  • This woman was in a population known to be vulnerable: the elderly. How severely do public health experts rate superbug dangers for people who aren’t old or very young and otherwise healthy?

  • They let this woman die rather than give her a little colloidal silver? That’s murder, but depending on doctors is insanity.

    • We may have to go back to pre-antibiotic-era treatments like colloidal silver. But as far as I know, there’s no research rating their effectiveness against some of these really bad microbes. A lot of them have been perfecting their defenses against our most advanced interventions. I can’t imagine they’ll be slowed down long by old-fashioned ones.

    • Perhaps the new President will also allow us to have our Mrs. Moffat’s Shoo-Fly Powders for Drunkenness again, tartar emetic is awesome. Those folks at the FDA really need their swamp cleaned.

    • They claim there is no way to make money off of colloidal silver, yet literally every alternative medicine magazine and site is littered with dozens of ads for it, and the FDA had to issue warnings to stop the fraudulent claims that it cures or prevents Ebola. The fact is that the supplement industry is making billions from things that often do not even contain the ingredient they advertise. They are making billions from things far cheaper than colloidal silver.

  • Come on guys. It’s sad they didn’t even try more exotic options like phage therapy. I’m from Russia and it’s already been used here in exUSSR in such cases for like, 50 years and has proven to be effective.
    Sad news.

    • Thank you! As someone that has researched phage in the US I cannot believe that they didn’t try it. I wish we could ask!

    • Let’s not forget that in our health care system, what gets done is frequently determined by what is covered. I’m speculating that phage therapy is regarded by insurers as experimental and probably not covered. Maybe her treatment team considered it and was overruled by their managers looking at whether the hospital would get paid for it. Or get paid enough.

    • As almost always these days our medical industry here in the US is not about curing people but rather about about how much money they can put into their grubby little hands. I have worked in the system for over 30 years and just can’t advise what they are doing these days. The Hippocratic oath is a joke now. Instead it is first let’s fill our pockets, keeping them stuck and coming back as long as possible. Then, oh our patient is dead, OK on to the next one.

  • Here in Germany our doctors don’t like giving you antibiotics for exactly the reasons described in this article. They should only be used as a last resort and not as the default way to treat the patient. If we don’t stop using antibiotics that often we will run out of working antibiotics very soon i think.

    • Over prescribing certainly contributes to the problem. In addition, many farmers (especially poultry farmers) put anti-biotics in animal feed. That’s another reason to eat organic meat.

  • Would be nice to know some symptoms this 70yr old woman had during her treatment. Publication of symptoms will make more people aware of the possible illness they have and will people will possibly take symptoms to an illness more serious and go see their doctor.

    • Don’t be absurd. There are no specific symptoms of a MDR bacterial infection. You will have to find some other imaginary illness to run to your doctor about. How about coccidioidomycosis?

    • @Rocky
      Maybe not “symptoms,” but certainly indications that a thorough workup of bio samples and patient history might uncover? Bacterial infections typically produce reactions (discharges, odors, swellings, etc.) that aren’t impossible to spot, even in routine complaints.

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