End of Antibiotics in View?

A report published by the CDC last week has confirmed that a Nevada woman who passed away in September was infected by an antibiotic-resistant strain of bacteria. Every single FDA-approved antibiotic, twenty six in total, were utilized to fight her infection and none were successful. This marks the first-ever case of a “superbug” officially documented in the US. At this point, it is still limited to this one case, but these findings have alerted the scientific community to be vigilant in finding the source of these bacteria and infections, along with cures.

This superbug was an infection caused by antibiotic-resistant bacteria called CRE (carbapenem-resistant enterobacteriaceae). Carbapenems are basically super antibiotics that are used as a last resort when illnesses do not respond to regular antibiotics. So when a bacteria is resistant even to carbapenems, it is a type of CRE. Disconcertingly enough, CDC Director Dr. Tom Frieden has called CRE “nightmare bacteria”. According to the CDC, CRE cause 9,000 drug-resistant infections per year and 600 related deaths, according to the CDC. Most CRE are resistant to at least one type of antibiotic, but in the Nevada woman’s case, the bacteria was resistant to all 26 FDA-approved antibiotics, hence a “superbug”.

A study published recently in the journal Proceedings of the National Academy of Sciences suggests that CRE are more common than previously believed. According to the study’s senior author William Hanage, an associate professor of epidemiology at the Harvard T.H. Chan School of Public Health in Boston, this bacteria can be passed from person to person without any symptoms arising, and thus, is spreading beyond the more observable case of disease. Due to this factor, the authors of the study believe it is important to increase genetic surveillance of CRE. The study also showed that CRE contain a large range of genetic material that makes them resistant to antibiotics, and that this genetic material can be transferred over to other CRE species, and cause them to also become resistant. Hanage says that if the unobserved transmission of the bacteria is found and studied, then we can formulate ways to prevent transmission of the bacteria in the first place.

Since bacteria always eventually form a resistance to any antibiotic, new antibiotics are always needing to be developed. In the case of a CRE, this resistance evolves much faster- faster than humans can develop an antibiotic to defeat it. And as drug resistance has been growing exponentially, antibiotic development has been grinding to a halt.

Though the underlying cause of CRE infection is still to be found, there are many factors that may contribute to developing this drug-resistant bacterial infection. Long hospital stays (especially in India or other countries that are more susceptible to this type of bacteria), travel, and exposure to many different types of antibiotics may all contribute to the acquiring of a CRE infection. While this seems to be a looming threat, it is important for individuals to be precautious and take watchful care in observing basic sanitary measures.

Image Credit: Rob Felt, Georgia Tech

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