No Antibiotic Could Cure This Patient

Nevada woman's death a stark reminder of major health threat

by Carleen Wild | Updated 14 Jan 2017 at 11:09 AM

Do not demand antibiotics for viral infections such as coughs or colds — and insist on hand-washing by your health care providers.

These are two of the best two pieces of advice offered by Dr. Amesh Adalja, a senior associate professor and clinical assistant professor at the Center for Health Security at the University of Pittsburgh Medical Center, whose comments come as yet another death is reported in the U.S. from a drug-resistant infection.

Public health officials in Nevada this week said a woman died in Reno in September from an incurable infection. The superbug, known as CRE, or carbapenem-resistant enterobacteriaceae, had spread throughout her body. Her health care team tried 26 different antibiotics on the infection — none of them worked.

"Only by using antibiotics appropriately and finding alternatives will we be able to solve this problem, which threatens all of modern medicine," said one infectious disease expert.

CRE is a general name for the bacteria that commonly live in the gut and that have developed resistance to the class of antibiotics called carbapenems. These are a last line of defense when other antibiotics fail.

“I am not surprised by this totally drug resistant bacteria,” Adalja told LifeZette. “There has been a steady march of resistance since the advent of penicillin and we are now at a point where total drug resistance is a reality.”

Antibiotic-resistant germs make more than two million Americans sick each year in the U.S.; about 23,000 will die from their infection. The woman in this most recent case had spent years in India, where multi-drug resistant bacteria are more common. While there, she developed a bone infection after breaking her femur and was hospitalized in India in the two years that followed.

It is unclear exactly why the woman ended up in Nevada, but her health care team is said to have cared for her in isolation and taken extreme precautions to keep the rest of the staff and patient population safe.

Related: The Biggest Public Health Threat We Face

Still, even with extreme precautionary measures, Adalja said the American public needs to understand these bacteria are commonplace and there is a strong chance we'll start to see more of them.

“Antibiotic resistance is a fact of life and it is only by using antibiotics appropriately and finding alternatives to antibiotics that we will be able to solve this problem, which threatens all of modern medicine,” he said. “The general public is starting to wake up to the threat of antibiotic resistance and the importance of using antibiotics judiciously — but there is still significant progress to be made as poor practicing patterns are still rampant.”

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