Pennsylvania woman infected with
"superbug" that is antibiotic-resistant

By Stacey Burling / Philadelphia Inquirer | Pittsburg Post-Gazette | May 27, 2016

A colorized scanning electron micrograph image made in 2006 shows the O157:H7 strain of the E. coli bacteria.A 49-year-old woman who came to a clinic in Pennsylvania with urinary tract infection symptoms is the first American found to have a new and frightening antibiotic-resistant bacteria, Army researchers reported Thursday.

While her particular kind of bacteria, a strain of E. coli, is treatable with some antibiotics, it is resistant to the antibiotic colistin, a drug sometimes used as a last resort for difficult-to-treat infections. What makes this "superbug" scarier is its potential to spread colistin resistance to other types of bacteria that are already highly resistant to multiple drugs, infectious disease experts said.

"It basically shows us that the end of the road isn't very far away for antibiotics that we may be in a situation where we have patients in our intensive-care units, or patients getting urinary tract infections, for which we do not have antibiotics," CDC Director Tom Frieden told The Washington Post, which first reported the case Thursday.

"It's another warning, not a death star, but a very strong warning that we really do have to be careful with antibiotics and use them optimally," said Neil Fishman, an infectious disease doctor who is associate chief medical officer of the University of Pennsylvania Health System.

Tom Fekete, an infectious disease specialist at Temple University Hospital, said he is hopeful about other drugs in the pipeline. As for whether the Pennsylvania case means the antibiotic era is ending, he said, "People have been saying that for about 20 years. I'm not giving up the ship."

In response to questions about the Pennsylvania woman, Gov. Tom Wolf said Thursday that the state is working closely with the Centers for Disease Control and Prevention and the Department of Defense, which tested the sample, to "coordinate an appropriate and collaborative response between federal, state, and local entities."

Officials would not say where in the state the patient lives or provide details about her condition.

The case was reported 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 truly pan-drug resistant bacteria."

Infectious disease experts have warned for years that overuse of antibiotics is weakening the effectiveness of human defenses against harmful bacteria by creating bugs that are immune to drugs.

Dr. Fishman said it is not unusual for doctors to see bacteria that are resistant to all treatments. "We see that all too commonly in the hospital today," he said. Such patients are isolated to keep their germs from spreading.

Colistin is an old antibiotic sometimes used as a last resort against "superbugs," including a family of bacteria known as CRE, which health officials have dubbed "nightmare bacteria," the Post reported.

In November, public health officials worldwide reacted with alarm when Chinese and British researchers reported finding the colistin-resistant strain in pigs, raw pork meat and in a small number of people in China. It was later discovered in Europe and elsewhere.

Officials would not say where in the state the patient lives or provide details about her condition.

The case was reported 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 truly pan-drug resistant bacteria."

Infectious disease experts have warned for years that overuse of antibiotics is weakening the effectiveness of human defenses against harmful bacteria by creating bugs that are immune to drugs.

Dr. Fishman said it is not unusual for doctors to see bacteria that are resistant to all treatments. "We see that all too commonly in the hospital today," he said. Such patients are isolated to keep their germs from spreading.

Colistin is an old antibiotic sometimes used as a last resort against "superbugs," including a family of bacteria known as CRE, which health officials have dubbed "nightmare bacteria," the Post reported.

In November, public health officials worldwide reacted with alarm when Chinese and British researchers reported finding the colistin-resistant strain in pigs, raw pork meat and in a small number of people in China. It was later discovered in Europe and elsewhere.

Colistin is more than half a century old and can be quite toxic. Drs. Fekete and Fishman said they rarely have to use it and that other, newer drugs are usually a better bet.