A superbug resistant to 26 different antibiotics killed a 70 year-old Nevada woman in September 2016, according to a CDC report.
Here are eight things to know:
1. In August 2016, providers identified a specific type of carbapenem-resistant Enterobacteriaceae, Klebsiella pneumoniae, which infected the patient who was admitted to an acute care hospital.
2. The CDC reports the patient returned to the United States in August 2016 following an extended trip to India. The patient had multiple hospitalizations in India during the two years before the acute hospital admitted her. The hospitalizations were related to a right femur fracture and subsequent right femur and hip osteomyelitis.
3. Providers collect the specimen on Aug. 19, 2016, and placed the patient in a single room under contact precaution.
4. Because the patient had the history of recent hospitalization outside the United States, CDC guidance advised providers to send the specimen to the agency for testing to assess the mechanism of antimicrobial resistance. The CDC confirmed the presence of New Delhi metallo-beta-lactamase, an enzyme that makes bacteria resistant to a wide range of beta-lactam antibiotics.
5. Upon admission on Aug. 18, 2016, providers first diagnosed the patient with systemic inflammatory response syndrome, which the CDC reports the infected right hip seroma likely caused. The patient later went into septic shock and died in early September 2016.
6. The antimicrobial susceptibility testing determined the specimen was resistant to 26 antibiotics as well as tigecycline. The CDC also tested the isolate for mcr-1 gene, but testing came back negative.
7. In the report, the CDC states it is uncommon to find CRE isolates that are resistant to all antimicrobials. Also, the CDC said facilities should ensure they implement the appropriate infection control contact precautions to slow the spread of such bacteria.
8. The CDC also stated when healthcare facilities admit a patient with recent exposure outside the United States or in U.S. regions with a higher CRE incidence, they should get a history of healthcare exposures and consider screening that patient for CRE.
