Report on patient death from Pan-Resistant K. pneumoniae published by CDC
Woman in the US dies from septic shock resulting from an infected right hip seroma after medical treatment in India.
While not unexpected this is very worrying. Reports of this kind are gradually increasing in frequency as once treatable infections are becoming multi-drug resistant and even, Pan-Resistant.
In this case, Pan-Resistant meant that the Klebsiella pneumoniae isolate was resistant to all 26 of the antibiotics cleared for use in the USA. Not a single treatment was effective. While last years hysteria inducing reports of an "Antibiotic Apocalypse" have possibly undermined reporting on AMR, the gravity of this report and others like it should not be understated. A decade ago, it was unthinkable that a patient would walk into a hospital that would be resistant to all the antibiotics we have, yet today, it is a possibility.
The CDC report does however state that this is still a rare occurrence. of the >250 carbapenem-resistant Enterobacteriaceae (CRE) collected as part of their surveillance program, 80% are sensitive to at least one aminoglycoside and nearly 90% are sensitive to tigecycline.
So, still no antibiotic apocalypse just yet, but the CDC recommends immediate measures be taken, specifically:
Pan-Resistant bacteria need to be identified quickly to ensure that infection control precautions are enacted in good time.
As the patient received inpatient treatment in India prior to admittance to hospital in the US, healthcare exposure outside of the country of residence should be recorded to identify high risk patients.
Chen L, Todd R, Kiehlbauch J, Walters M, Kallen A. Notes from the Field: Pan-Resistant New Delhi Metallo-Beta-Lactamase-Producing Klebsiella pneumoniae — Washoe County, Nevada, 2016. MMWR Morb Mortal Wkly Rep 2017;66:33. DOI: http://dx.doi.org/10.15585/mmwr.mm6601a7