Day 6

An American woman just died from a superbug resistant to 26 different antibiotics

Last week, public health officials announced that a woman in Nevada had died from a superbug resistant to every available antibiotic in the United States. Lance Price is the Director of the Antibiotic Resistance Action Center at George Washington University and he's working on solutions to what he calls one of the greatest public health threats of our time.
Klebsiella Pneumoniae, also known as Friedlander's bacillus, is associated with healthcare-acquired infections. (klebsiella-pneumoniae.org)
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A 70-year-old Nevada woman has died after contracting a superbug that could not be treated with any known antibiotic. As microbiologist Dr. Lance Price tells Day 6 host Brent Bambury, cases like this will soon be all too common.

"This is a huge problem. In the past, we'd see infections that were treatable with one or two or, maybe if we're lucky, three drugs. Now we're looking at bacteria that are untreatable," Price says. "This is a whole new realm that we're entering"

The woman at the centre of the story had returned to Reno in August after a long stay in India, where she had been in and out of hospital after breaking her right leg. An infection got into the bone and then spread to her hip.

She died in September.

"It's not so unusual for someone to die of Klebsiella pneumoniae. That's a common pathogen in our hospitals, but what was unusual about this one is that it was resistant to all 26 different antibiotics that we have," says Price, who founded the Antibiotic Resistance Action Center at George Washington University two years ago.

The Centers for Disease Control and Prevention in the U.S. released details of the Nevada woman's death on January 13, 2017. Her identity has not been released.
 

Dr. Lance Price founded the Antibiotic Resistance Action Center at George Washington University in an attempt to find out-of-the box solutions to antibiotic resistance. (ARAC)



Typically, a persistent pathogen can be killed with a potent, last line of defense antibiotic called Colistin, also known as also known as polymyxin E.  The drug is so strong it was originally abandoned due to high rates of nephrotoxicity, or severe damage to kidneys.

"We're so desperate we've been using this toxic antibiotic, but now we've lost that one too," Price says.
 

Spreading the superbugs

Dr. Price says one of the major concerns is how easily these pathogens can spread.

"We don't know who else was exposed to that bacteria. Not just in the hospital but how many people she came in contact with in the community," he says.

Humans can host some of the worst superbugs, like Klebsiella, e.coli and Staphylococcus aureus, without showing symptoms. And they can passed around without our knowledge.

The Klebsiella pneumonia organism (foreground) and susceptibility panels (rear) are shown at the Berkeley Medical Center Laboratory in Martinsburg, West Virginia, U.S. (REUTERS/Gary Cameron)
"They can get on planes with us. They can be in our food products. People can carry them indefinitely before succumbing to an infection or passing them to someone else who has a weaker immune system, who then succumbs to an infection", says Price.

It means that the superbug that killed the woman from Nevada is likely somewhere in the U.S. right now.

"This person probably picked up this strain in India, got on a plane and brought it home," Price says. "Maybe we're lucky," he says. "Maybe she didn't spread it. But this is just one case."
 

Sounding the alarm

According to a U.K. report released in May and chaired by economist Jim O'Neill, antibiotic resistant bacteria could kill ten million people a year by 2050 if left unchecked, That's roughly one every three seconds.


The report also says if antibiotics continue to lose their sting, resistant infections will sap $100 trillion from the world economy over the next 33 years.




These predictions only account for infection-related deaths, not for procedures that are only safe or possible because of antibiotics, such as hip and joint replacements, gut surgeries, C-sections, chemotherapy and organ transplants.

The report urges the world's governments take drastic steps now, a stance shared by Dr. Lance Price.
 

Why more drugs may not be the answer

"There is a bacterium out there that is resistant to everything.  We desperately need a new antibiotic for that strain. But I don't think the ultimate answer is more antibiotics," he says.

Price thinks the solution could be found in changing how we use the antibiotics that we already have, and points out that the pattern of staying one step ahead of ever-changing, quickly adapting bacteria is a race we can't win.

"Alexander Fleming discovered the first antibiotic in 1928. In the '40s, they were introduced to human medicine. Quickly thereafter we started seeing resistance. So what do we do? We find a new antibiotic. That works for a few years and then we have resistance again," he says.

This boom-bust cycle happens every few years. Price says a better plan might be to address the more immediate and more practical misuses of antibiotics.

"We should stop feeding antibiotics to animals to help them grow faster. We should stop using antibiotics to mask bad hygiene in hospitals by just giving them to everybody."
 

Disconnected from danger


Price tells Bambury there are many problems with the way we use antibiotics and with our attitudes towards them. But one of the biggest issues is our inability to understand the immediate dangers.

Whether it's a lack of comprehension about how antibiotics are used in food, an over-prescribing and over-reliance in the medical communit, or a lack of hygiene, it all adds up to a dangerous ignorance.

"I think people aren't as connected to this issue as they should be," he says.

To hear Brent Bambury's conversation with Dr. Lance Price, download our podcast or click the 'Listen' button at the top of this page.