The Hamilton Spectator

Superbug precursor found in U.S. again

- MIKE STOBBE

NEW YORK - A New York City patient was infected with bacteria that had a special type of resistance to antibiotic­s last year, the earliest known case in the U.S. of bacteria that could lead to a superbug impervious to medication­s.

The bacteria were found in a patient who was treated in May of 2015 and reported in a study published Monday. They were discovered by an Iowa company that’s been testing thousands of bacteria collected from patients from around the world over the last two years.

The company, JMI Laboratori­es, found hundreds globally that were resistant to colistin, an old, powerful antibiotic that is now seen as a drug of last resort. Health officials worry that these bacteria will spread their resistance to last-resort antibiotic­s to other bacteria that are already resistant to frontline antibiotic­s, creating germs that can’t be killed by any known drugs.

A similar infection was reported in a Pennsylvan­ia woman earlier this year and initially reported as the first known U.S. case. But the New York case happened almost a year before, and scientists now believe these bacteria were likely in people in the U.S. even earlier.

Why are people worried?

Since the 1940s, doctors have used antibiotic­s to beat back a large number of dangerous bacterial diseases. Over the decades, bacteria have adapted to become resistant to more and more of the drugs. An exception has been an old antibiotic called colistin. But recently scientists have spotted evidence of colistin-resistant infections in animals and people in China, Europe and Canada.

Are these colistin-resistant germs some new breed of bacteria?

No. In both the U.S. cases, they were E. coli bacteria, a common type of germ found in the gut. In both cases, while they were resistant to colistin, they were vulnerable to more common antibiotic­s and were not hard to treat. “It’s not an immediate threat,” said Mariana Castanheir­a, one of the study’s authors.

So what’s the problem?

Bacteria often mingle and swap genetic material. The E. coli bacteria in New York and Pennsylvan­ia were vulnerable to other antibiotic­s, but some other germs are nearly impervious. Colistin is reserved for germs that already resist one of the other last lines of defence — antibiotic­s called carbapenem­s. If carbapenem-resistant bacteria absorb the colistin-resistance gene, that could set the stage for creation of supergerms impervious to all known antibiotic­s.

When did this form of antibiotic resistance first appear?

Scientists think the colistin-resistant gene was in bacteria in livestock in China as far back as the 1980s. Reports of these bacteria in humans date back to 2008. Until this study, none of the reported U.S. infections were thought to have occurred before this year.

But the new report found the New York case in 2015, and Castanheir­a said it’s likely colistin-resistant bacteria were in the United States before that.

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