A woman in Reno, Nev., died of a bacterial infection resistant to all antibiotics available in the US in early September 2016. The case was publicly reported for the first time on Thursday in the CDC's Morbidity and Mortality Weekly Report.
The unidentified woman was in her seventies and had previously traveled to India — where multidrug-resistant bacteria are more common — for an extended period of time. In India, the woman was hospitalized multiple times over two years for a right femur fracture and subsequent bone infection of the right femur and hip. After being admitted to an acute care hospital in Reno on Aug. 18, clinicians detected an infection with carbapenem-resistant Enterobacteriaceae — specifically Klebsiella pneumoniae — resistant to all 26 different antibiotics available in the U.S.
The patient was cared for in isolation and tests on patients in the same unit did not find additional CRE, according to the CDC report.
The report's authors concluded that U.S. healthcare facilities should obtain a patient's history regarding exposures to healthcare environments outside of the region during patient screening and consider testing for CRE when a patient reports healthcare exposure in an area with higher rates of CRE activity.
"I think this is the harbinger of future badness to come," James Johnson, MD, a professor of infectious diseases medicine at the University of Minnesota in Minneapolis, told STAT when asked about the case.
Dr. Johnson said it's likely others in the U.S. are harboring these bacteria in their guts and could become sick at some point in time in the future.
On the dangers of the growing threat of antibiotic resistance, Dr. Johnson told STAT:
"People have asked me many times 'How scared should we be?' ... 'How close are we to the edge of the cliff?' And I tell them: We're already falling off the cliff. It's happening. It's just happening — so far — on a relatively small scale and mostly far away from us ... so it doesn't have the same emotional impact."
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