E.coli resistant to an antibiotic of last resort has appeared in the United States. The Washington Post reports, “the superbug that doctors have been dreading just arrived.”
For the first time, researchers have 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 signal "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 truly pan-drug resistant bacteria."
Colistin is the antibiotic of last resort for particularly dangerous types of superbugs, including a family of bacteria known as carbapenem-resistant Enterobacteriaceae, or CRE, which health officials have dubbed "nightmare bacteria."
Fortunately for the woman in Pennsylvania this “nightmare bacteria” is still treatable with other antibiotics.
But, that’s only good news about this discovery.
“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 said in an interview Thursday.
"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 need to be.”
The end of antibiotics is at hand. “We’re here. We’re in the post-antibiotic era. There are patients for whom we have no therapy, and we are literally in a position of having a patient in a bed who has an infection, something that five years ago even we could have treated, but now we can’t,” Dr. Arjun Srinivasan, associate director at the CDC told PBS Frontline back in 2013.
“It’s hard to imagine worse news for public health in the United States,” Lance Price, director of the Antibiotic Resistance Action Center and a George Washington University professor said in a statement Thursday about the Pennsylvania case.
The rapid evolution of antibiotic-resistant bacteria is linked to overuse of antibiotics on livestock. According to Price, the common use of colistin on livestock in China likely led to the evolution of the resistance gene.
Antibiotics are intended to kill all bacteria targeted, but the bacteria which survive develop a resistance to the medicine and are able to pass the trait on through reproduction. Because most bacteria reproduces quickly, the evolution happens fast. This is leading to what are being deemed “superbugs,” or infectious diseases completely resistant to antibiotic medicines which will leave people who contract treatable infections such as E.coli, MRSA, or gonorrhea unresponsive to treatments.
Price said this gene was first detected in November and now colistin-resistant E. coli has found its way into pigs and a person in the United States. Price observed:
“If our leaders were waiting to act until they could see the cliff’s edge—I hope this opens their eyes to the abyss that lies before us.”
Research into antibiotics is not profitable for drug companies so the last new class of antibiotics was discovered in the 1980s. Drugs that are taken daily are more profitable for pharmaceutical companies than antibiotic taken only for a few days.
“In private sector for many companies it doesn't make financial sense,” Dr. Yohei Doi, a University of Pittsburgh infectious disease professor who specializes in antimicrobial resistance research, said. “It's getting in the way of the necessary innovation in the field.”
Congress should be funding more research into discovering new antibiotics, but that would mean admitting bacteria are evolving and the free market isn’t working. Welcome to the edge of the abyss.