A Woman Just Died From an Infection No U.S. Antibiotics Could Beat

A superbug that resisted all available bacteria kills a woman in Reno, Nevada.

The woman from Washoe, Nevada was in her 70s and had an infection in her hip. She’d contracted it in a hospital in India after fracturing her leg. Doctors in Reno attempted to tame her infection, trying every antibiotic they had. 26 in all. None of them worked, not even colistin, their last line of defense. The woman died.

The CDC’s report on her case, issued January 13, is sending a chill through the medical world: They’ve been worried for years about the appearance of a superbug that beats all of our antibiotics. Is this what happened here? It turns out that maybe she could have been saved using an antibiotic called fosfomycin not approved in the U.S. for treating the kind of infection she had. Even so, her case has troubling implications.

Post-mortem testing of the woman’s bacteria revealed that something new is going on. Previous infections that have been resistant to treatment with colistin have had a single critical gene, MCR-1. This woman’s bacteria didn’t have this gene, so there’s some previously undiscovered mechanism at work.

MCR-1 was first found in E.coli (NIAID)

Even prior to this, the protective firewall provided by colistin has been cracking. The drug was discovered in 1949 but went largely unused for a long time due to its harmful effect on the kidneys. It came to prominence as a last-line drug after bacteria strains showed signs of developing resistance to other key antibiotics — colistin had been so infrequently used meant that bacteria hadn’t yet had the chance to develop resistance to it.

But those days are apparently over. Colistin has become a popular, inexpensive additive to animal feed as both an antibiotic and also a way to quickly add muscle to animals. Agricultural demand for the drug reached 11,942 tons per year in 2015, and is expected to reach 16,500 tones by 2022. (73% of it is used in Asia, and 28.7% in Europe.) And the MCR-1 gene is now found in livestock and humans, suggesting that colistin’s days as a super-antibacterial are numbered.


One of the scariest aspects of the MCR-1 gene, by the way, is that it doesn’t live in a bacteria’s chromosome. Instead, it’s contained in a plasmid, a small, unattached bit of DNA. What’s worrisome about this is that, being independent, it can attach to any bacteria, thus making it resistant to colistin. The danger is that an MCR-1 plasmid, having been consumed in pork or chicken, attaches to some other bacteria it encounters in your gut. This is clearly already happening in patients carrying the MCR-1 gene. And it may a lethal recipe for the evolution of pan-resistant bacteria. 

Fosfomycin, the antibiotic to which the woman’s bacteria showed some reaction post-mortem, is another old drug for which little resistance has yet been developed. It’s approved in the U.S. for treatment of urinary-tract infections, but not for intravenous use in fighting infections. Some wonder if and when the U.S. FDA will widen its availability for use.

As for the woman in Nevada, she was, thankfully, kept well-isolated from other patients and staff. Samples taken from the hospital have so far shown no sign of her bacteria anywhere, so a deadly outbreak seems to have been avoided. For now.

LinkedIn meets Tinder in this mindful networking app

Swipe right to make the connections that could change your career.

Getty Images
Swipe right. Match. Meet over coffee or set up a call.

No, we aren't talking about Tinder. Introducing Shapr, a free app that helps people with synergistic professional goals and skill sets easily meet and collaborate.

Keep reading Show less

4 reasons Martin Luther King, Jr. fought for universal basic income

In his final years, Martin Luther King, Jr. become increasingly focused on the problem of poverty in America.

(Photo by J. Wilds/Keystone/Getty Images)
Politics & Current Affairs
  • Despite being widely known for his leadership role in the American civil rights movement, Martin Luther King, Jr. also played a central role in organizing the Poor People's Campaign of 1968.
  • The campaign was one of the first to demand a guaranteed income for all poor families in America.
  • Today, the idea of a universal basic income is increasingly popular, and King's arguments in support of the policy still make a good case some 50 years later.
Keep reading Show less

Why avoiding logical fallacies is an everyday superpower

10 of the most sandbagging, red-herring, and effective logical fallacies.

Photo credit: Miguel Henriques on Unsplash
Personal Growth
  • Many an otherwise-worthwhile argument has been derailed by logical fallacies.
  • Sometimes these fallacies are deliberate tricks, and sometimes just bad reasoning.
  • Avoiding these traps makes disgreeing so much better.
Keep reading Show less

Why I wear my life on my skin

For Damien Echols, tattoos are part of his existential armor.

  • In prison Damien Echols was known by his number SK931, not his name, and had his hair sheared off. Stripped of his identity, the only thing he had left was his skin.
  • This is why he began tattooing things that are meaningful to him — to carry a "suit of armor" made up the images of the people and objects that have significance to him, from his friends to talismans.
  • Echols believes that all places are imbued with divinity: "If you interact with New York City as if there's an intelligence behind... then it will behave towards you the same way."
Keep reading Show less