ISSN 2330-717X

Superbug Acquired In India Kills Patient; No Antibiotic Could Save Her – OpEd


An article titled “Woman Killed by a Superbug Resistant to Every Available Antibiotic” by Helen Branswell reproduced from STAT  in Scientific American on January 13, this year is very scary. STAT is “a new national publication focused on finding and telling compelling stories about health, medicine, and scientific discovery”.

The alarming finding was that a woman in her 70s contracted a superbug which her physicians could not control by any of the 26 antibiotics available in USA. The infection spread throughout her body and she succumbed in spite of the best medical care.

According to the news story, the woman spent considerable time in India, where multi-drug-resistant bacteria are more common than they are in the US. She had broken her right big thighbone while she was in India a couple of years ago. She later developed a bone infection and was hospitalized many times in India in the two years that followed. Her last admission to a hospital in India was in June 2016.

After her return to USA, she was admitted to a hospital in Reno where the doctors discovered that she was infected with a bacterium, which commonly live in the gut. What was of great concern was the fact that these bacteria have developed resistance to the class of antibiotics called carbapenems — an important last-line of defense used when other antibiotics fail.

Morbidity and Mortality Weekly Report, published by the US Centers for Disease Control and Prevention (CDC) reported the case.

The authors of the report noted that this case underscores the need for hospitals to ask incoming patients about foreign travel and about whether they had recently been hospitalized elsewhere.

The SLAT quoted CDC Director Dr. Tom Frieden as saying that these carbapenem-resistant enterobacteriaceae (CREs) are called “nightmare bacteria” because of the danger they pose for spreading antibiotic resistance.

Testing at the hospital revealed that she was resistant to 14 drugs, all the drug options the hospital had.

“A sample was sent to the CDC in Atlanta for further testing, which revealed that nothing available to US doctors would have cured this infection. Kallen admitted people in this field experience a sinking feeling when they’re faced with a superbug like this one,” the article reported. Dr. Alexander Kallen is a medical officer in the Centers for Disease Control and Prevention’s division of health care quality promotion.

The woman received treatment in isolation. The staff that treated her followed strict infection control precautions to prevent spread of the superbug in the hospital.
We cannot dismiss the report, though it refers to only one patient. Those keen to know more about antibiotic resistance and related news can have it here.

Are we conscious of the impending doom? Is it not too late?

An article titled “Emerging antibiotic resistance in bacteria with special reference to India” is a review of the topic published in 2008. The article describes how the epidemiology of antibiotic resistance is dealt with. The article also highlights the implication of the wide use of antibiotics in animals. The anti biotic resistance may increase steadily and numbers of newer antibiotics may decrease. It would become increasingly difficult to treat infections.

An article describes the emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK. It is a molecular, biological, and epidemiological study in The Lancet Infectious Diseases published in 2010.

The WHO noted that the 2015 WHO multi-country survey revealed the widespread public misunderstanding in India about antibiotic usage and resistance.

“Three quarters (75%) of respondents think, incorrectly, that colds and flu can be treated with antibiotics; and only 58% know that they should stop taking antibiotics only when they finish the course as directed.

More than three quarters (76%) of respondents report having taken antibiotics within the past 6 months; 90% say they were prescribed or provided by a doctor or nurse.

While 75% agree that antibiotic resistance is one of the biggest problems in the world, 72% of respondents believe experts will solve the problem before it becomes too serious.”

A couple of years ago, I suffered from a urinary tract infection. A closer diagnosis revealed that I have already acquired resistance to over half a dozen common antibiotics. My physician could locate an effective antibiotic in time! I have been scrupulously cautious about the use of antibiotics. Obviously, that was not enough!

It seems that superbugs have already won. This shocking reality must wake us up from deep slumber. The WHO has provided complete information on drug resistance here. These booklets must be made compulsory reading material for all, particularly in the medical field.

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Dr. K S Parthasarathy

Dr. K S Parthasarathy is former Secretary, Atomic Energy Regulatory Board and a former Raja Ramanna Fellow in the Strategic Planning Group, Department of Atomic Energy, Mumbai. Dr. K S Parthasarathy may be contacted at [email protected]

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