A field report published on 13 January 2017, by the Centre for Disease Control and Prevention (CDC), U.S.A, revealed a unique case of a Washoe County resident who was infected by a superbug during her extended visit to India last year. The 70-year old unnamed woman died of septic shock as her body was unresponsive to 26 different antibiotics available in the U.S.
On 18th August 2016, she was admitted to an acute care Reno hospital after receiving multiple treatments over two years in India for right femur fracture and subsequent osteomyelitis of the right femur and hip. U.S. doctors speculate that hospital treatments in India infected her with the superbug as such bacteria are uncommon in the U.S. Her most recent hospitalisation in India was in June 2016.
CDC doctors later discovered that the woman was infected with CRE (carbapenem-resistant enterobacteriaceae) – the general name of the bacteria which commonly resides in the gut and even fends off carbapenems, the antibiotic used as a last resort when all other antibiotics fail. CDC Director Dr. Frieden named CRE ‘nightmare bacteria’ due to its power to spread antibiotic resistance in the host body and easily communicate in hospital settings.
The woman was put in insolation in the Reno hospital and was unresponsive to all 14 drugs administered. A wound sample sent to CDC Atlanta later revealed that the CRE, identified as Klebsiella pneumonia, was also unresponsive to 12 other antibiotics. Further tests concluded the presence of New Delhi metallo-beta-lactamase (NDM-1) – the main enzyme responsible for the ineffectiveness of carbapenems. After undergoing treatment in the US for two months, the woman died in September last year as her body rejected all drugs and deteriorated rapidly.
CRE infection has deadly consequences when it enters the bloodstream and kills half the patients affected by it. This is the second instant of the NDM-1 bacteria infecting a foreign national. The bug was first identified in 2009 when it was found in a Swedish patient hospitalised in India.
Lei Chen, an author of the CDC report and a senior epidemiologist with Washoe County Health District, found the whole experience overwhelming as it was her first encounter with such multi-drug resistant bacteria in her area. Resistance rate is low in countries like USA, but common in India – a country known to suffer from major superbug issues. The problem of unregulated sale of prescription drugs makes the rate of resistance to antibiotics high in India. Furthermore, unsanitary living conditions, poverty, misuse of drugs, rising use of antibiotics for boosting poultry growth aids bacteria to become multi-drug resistant.