A woman in her 70s has died in hospital in the US after contracting a superbug infection resistant to all antibiotics while travelling in India. The woman died in Reno, Nevada, after being treated with 26 different antibiotics in an attempt to cure an infection of Klebsiella pneumoniae.
The woman had been treated repeatedly as an in-patient in India after fracturing her hip. After returning to the US, she was admitted to hospital on 25 August 2016 and died of septic shock weeks later, according to a report by the US's Centers for Disease Control and Prevention.
The patient was treated in isolation once the nature of the infection had been identified, which appears to have effectively limited its spread. Medics in Nevada report that tests on other patients in the same unit of the Nevada hospital have not contracted the superbug.
Another strain of multi-resistant Klebsiella killed 16 people in a hospital in Manchester during an outbreak in 2014.
Klebsiella lives in the human gut, and if it spreads throughout the body during an infection, it can cause pneumonia, urinary infections, blood infections and meningitis. It is showing increasing antimicrobial resistance, including to carbapenem, an antibiotic of last resort.
Director of the CDC Tom Frieden has previously described carbapenem-resistant enterobacteria (CRE) as "nightmare bacteria". In addition to their antibiotic resistance, they kill up to half of people who become infected and can easily spread their resistance genes to other bacteria via small transmissible loops of DNA called plasmids.
Although the Nevada Klebsiella death is thought to be an isolated case, researchers say that this is unlikely to be the last death from the superbug in the US.
"It's possible that this is the only person in the US and she had the bad luck to go to India, pick up the bad bug, come back and here it is, we found her and now that she's dead, it's gone from the US. That is highly improbable," James Johnson, an infectious disease researcher at the University of Minnesota told STAT News.
Other researchers say that this case is a wake-up call for boosting efforts to tackle antimicrobial resistance.
"If we're waiting for some sort of major signal that we need to attack this internationally, we need an aggressive program, both domestically and internationally to attack this problem. Here's one more signal that we need to do that," said Lance Price of the Antibiotic Resistance Action Center at George Washington University.