A new case study by the Centers for Disease Control and Prevention detailed a rare case of a superbug that is resistant to all known antimicrobial drugs available in the United States.
The study, described in the Morbidity and Mortality Weekly Report, describes the case of a woman in her late 70s who contracted a rare superbug during her extended stay in India. According to the report, the woman came back in the United States in early August 2016. During her stay in India, the patient received multiple hospitalizations due to a right femur fracture and subsequent osteomyelitis of the right femur and hip.
"We feel it likely this is where the infection was acquired," said Randall Todd of the Washoe County, Nevada health department in a report from NBC News. "Hospitals should be reminded that they have got to take a travel history and be open to the possibility that an uncommon infection might be responsible."
The woman was admitted in acute care on Aug. 18, 2016 with primary diagnosis of systematic inflammatory response syndrome, which is likely to be the result of an infected right hip seroma.
Wound sample collected from the woman last Aug. 19, 2016 revealed that the infection was caused by carbapenem-resistant Enterobacteriaceae called Klebsiella pneumonia. CRE is a family of bacteria that have developed resistance to a whole class of bacteria.
The CRE that infected the women carries a mutation called NDM-1. Due to this mutation, the bacteria became a near-perfect superbug. Antimicrobial susceptibility testing in the US indicates that the bacteria isolated from the wound of the Nevada woman were resistant to all 26 antibiotics available in the U.S.
However, the doctors involved in the case noted that the bacteria might be vulnerable to an antibiotic called fosfomycin, which is only available in pill form in the U.S. and is only approved to treat uncomplicated cystitis. The intravenous formulation of fosfomycin is available in other countries.
However, the woman has already succumbed to the infection early September after developing septic shock.