A case of pan-drug resistant NDM-producing K. pneumoniae CPE that resulted in a fatal infection in a US woman has prompted a lot of coverage and discussion on both sides of the Atlantic. Although this report is concerning, not least because the patient succumbed to the infection, this is hardly a new scenario. There are parts of the world where pan-drug resistant CPE are commonplace and have been for years (for example parts of India, the likely country of origin of the organism in this case). Before getting to the case report in detail, let’s take a moment to review this case series from India, published in 2014. 13 patients with pan-drug resistant Gram-negative bacteria (7 of whom were infected with K. pneumoniae, 4 of these 7 died) were reported in a specialist cancer treatment centre over 18 months over 2012/13. This evidence, from half a decade ago, shows that pan-drug resistant CPE is by no means a new phenomenon! Continue reading
Guest blogger and Acute Medicine trainee Dr Nicola Fawcett (bio below) writes…As the local Prophet of Antibiotic Resistance Doomsday to our population of hospital physicians, I’m always interested in finding out if the pan-drug-resistant superbug has emerged that is going to wipe us all out, for credibility purposes if nothing else. (Resistance Is Coming! Prepare thyself! Wash thy hands and document thy indication and duration or face Everlasting audits and perpetual personal protective equipment!). For the record – I’m actually a Registrar in Acute and General (Internal) Medicine. I’m doing some time in the world of ID/Micro/Genomics in the hope that it will help me work out whether it’s ok to just hand out co-amoxifrusiclavamide + nebs to everyone if not sure what’s going on. However this question seems rather inextricably linked to antibiotic resistance, and having spent some time now with people who seem to know what they’re doing, I’m increasingly flabbergasted at the massive divide between the views of microbiologists who see the latest data, and the views of the common garden hospital physician. Therefore my side-mission, if you like, has become to spread the good, or rather, spectacularly bad news that antimicrobial resistance is currently spreading around our biosphere at a scale and speed at which we simply cannot react fast enough.