Friday, May 27, 2016

The superbug that doctors have been dreading just reached the US – Washington Post

CRE, a family of bacteria pictured here, is considered one of the deadliest superbugs because it sets off infections that are frequently resistant to most antibiotics. (Centers for Disease Control and Prevention/Reuters)

For the initial time, researchers have actually found a person in the United States carrying bacteria resistant to antibiotics of last resort, an alarming development that the top U.S. public health official says could mean “the end of the road” for antibiotics.

The antibiotic-resistant strain was found last month in the urine of a 49-year-old Pennsylvania woman. Defense Department researchers determined that she carried a strain of E. coli resistant to the antibiotic colistin, according to a study published Thursday in Antimicrobial Agents and Chemotherapy, a publication of the American Society for Microbiology. The authors wrote that the discovery “heralds the emergence of a actually pan-drug resistant bacteria.”

Colistin is the antibiotic of last resort for particularly dangerous types of superbugs, including a family of bacteria known as CRE, which health officials have actually dubbed “nightmare bacteria.” In some instances, these superbugs kill up to 50 percent of patients that become infected. The Centers for Disease Control and Prevention has actually called CRE among the country’s most urgent public health threats.

In this Nov. 2015 video, Centers for Disease Control and Prevention director Dr. Thomas Frieden said that the CDC is committed to fighting antibiotic resistance. (YouTube/CDC)

It’s the initial time this colistin-resistant strain has actually been found in a person in the United States. In November, public health officials global reacted along with alarm as soon as Chinese and British researchers reported finding the colistin-resistant strain in pigs and raw pork and in a small number of people in China. The deadly strain was later discovered in Europe and elsewhere.

“It basically shows us that the end of the road isn’t fairly far away for antibiotics — that we might be in a situation where we have actually patients in our intensive care units, or patients getting urinary-tract infections for which we do not have actually antibiotics,” CDC Director Tom Frieden said in an interview Thursday.

“I’ve been there for TB patients. I’ve cared for patients for whom there are no drugs left. It is a feeling of such horror and helplessness,” Frieden added. “This is not where we should be.”

CDC officials are working along with Pennsylvania health authorities to interview the patient and family to identify exactly how she might have actually contracted the bacteria, including reviewing recent hospitalizations and various other health-care exposures. The CDC hopes to screen the patient and her contacts to see if others may be carrying the organism. Local and state health departments additionally will certainly be compiling cultures as portion of the investigation.

The woman was treated in an outpatient military facility in Pennsylvania, according to a Defense Department blog write-up concerning the findings. Samples were sent to the Walter Reed National Military Medical Focus for first testing. Additional testing was done by a special Defense Department system that tracks multi-drug-resistant organisms.

Thursday’s study did not disclose further details concerning the Pennsylvania woman or the outcome of her case. The authors could not be reached for comment. A spokesman at the Pennsylvania Department of Health was not immediately available to comment on the case.

Sen. Robert P. Casey Jr. (D-Pa.) said he is concerned concerning the reports. In a statement, Casey said he supported legislation for and participated in hearings concerning antibiotic-resistant bacteria, which he said “present an urgent public health problem that we should focus on intensively.”

He said he planned to grab a full briefing on the case in the coming days.

Scientists and public health officials have actually long warned that if the resistant bacteria keep on to spread, treatment selections could be seriously limited. Timetable operations could become deadly. Minor infections could become life-threatening crises. Pneumonia could be a lot more and a lot more difficult to treat.

Already, doctors had been forced to rely on colistin as a last-line defense versus antibiotic-resistant bacteria. The drug is hardly ideal. It is a lot more compared to half a century old and can easily seriously damage a patient’s kidneys. And yet, because doctors have actually run from weapons to fight a growing number of infections that evade more-modern antibiotics, it has actually become a critical tool in fighting off some of the most tenacious infections.

Bacteria produce antibiotic resistance in two ways. Lots of acquire mutations in their own genomes that permit them to withstand antibiotics, even though that ability can’t be shared along with pathogens outside their own family.

Other bacteria rely on a shortcut: They grab infected along with something called a plasmid, a small piece of DNA, carrying a gene for antibiotic resistance. That makes resistance genes a lot more dangerous because plasmids can easily make copies of themselves and transfer the genes they carry to various other bugs within the same family as well as jump to various other families of bacteria, which can easily then “catch” the resistance directly free of having to produce it through evolution. The colistin-resistant E. coli found in the Pennsylvania woman has actually this type of resistance gene.

Public health officials say they have been expecting this resistance gene to turn up in the United States.

“This is certainly alarming,” said David Hyun, a senior officer leading an antibiotic-resistance project at the Pew Charitable Trust. “The truth that we found it in the United States confirms our suspicions and adds urgency to actions we should job on antibiotic stewardship and surveillance for this type of resistance.”

This animated video from 2013 from the Centers for Disease Control and Prevention highlights the key points and graphics of the “Antibiotic Threats in the United States” report. (YouTube/CDC)

Late last year, as portion of a broader budget deal, Congress agreed to provide hundreds of millions of dollars to the federal agencies engaged in the battle versus antibiotic-resistant bacteria.

The largest chunk of that money, a lot more compared to $150 million, was slated to go to the CDC as portion of an effort to build and strengthen capacity at state and local health departments to Avoid and monitor superbug outbreaks.

Other funding went to the National Institutes of Health for research on combating antimicrobial resistance, as well as to an agency known as BARDA, which works on national preparedness for chemical and biological threats, including producing brand-new therapies.

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