Highlights need for faster testing, new therapeutics, and better use of antibiotics
Earlier this month, the Centers for Disease Control and Prevention (CDC) reported that a woman in Nevada died from a bacterial strain that was resistant to all FDA-approved antibiotics. The woman had been traveling in India, where she was hospitalized for a bone fracture and acquired the infection. When she returned to the U.S., she was admitted to an acute care hospital and found to have Klebsiella pneumoniae, one of the carbapenem-resistant Enterobacteriaceae (CRE).
The hospital followed CDC protocol, sending an isolate to the agency to figure out the biological mechanism responsible for the antibiotic resistance. The CDC analysis detected New Delhi metallo-beta-lactamase (NDM), which confers resistance to a wide swath of antibiotics. The strain did not have the mcr-1 gene, which has been found in other cases of completely resistant bacteria. Still, the organism was resistant to all 26 antibiotics tested, though one drug that is not approved for intravenous use in the U.S. might have been effective.
The CDC report makes clear that this kind of broad resistance is still quite uncommon in bacteria, stating that in the CRE isolates tested through its emerging disease program, 80% were susceptible to at least one antibiotic in the streptomycin family and almost 90% responded to tigecycline, a newer drug developed to fight antibiotic-resistant bacteria.
Antibiotic Stewardship
This superbug report highlights the ongoing need to up our game in the battle against antibiotic resistance. The Nevada hospital handled the situation as well as possible: the patient was isolated once CRE was detected, and patients in the same unit were monitored closely for CRE. But as this situation becomes more commonplace, we believe that better testing — faster, perhaps more specific, and providing information about the mechanism of drug resistance — will be immensely helpful for rapid response and containment. We also need new antibiotic options from pharma and biotech companies, and consideration from FDA for antibiotics that are not currently approved in this country. While new antibiotics might be a longer term goal, a focus on eliminating unnecessary antibiotic prescriptions can help today. Studies indicate that up to 50% of antibiotics prescribed in hospitals are unnecessary or inappropriate. Antibiotic resistance is a threat to public health that can be reduced by stopping the prescription and use of antibiotics when they are not needed.
Get Smart for Healthcare, a CDC campaign, focuses on improving prescribing practices in inpatient healthcare facilities. Learn more about this program at the CDC website.
Do Your Part
Lastly, it’s important for all of us to do our part to prevent the spread of these bacteria. As patients, you have the right to protect yourself and your family. Be sure that healthcare workers clean their hands before giving care, watch out for signs of infection, and be smart about antibiotics. For healthcare workers, check out the CDC resource page to learn more about how you can protect patients and stop outbreaks.
