Blog | Thursday, April 17, 2014

We're in the post-antibiotic age


We’re so very lucky to have lived in the “age of antibiotics.” However, most of us were neither alive nor cognizant prior to 1943, so we don’t have a concept of the morbidity and mortality prevented by antibiotics. In some regards, this pre-1943 period is the future we’re facing.

Author and science journalist Maryn McKenna has a wonderful article up on medium.com where she discusses this post-antibiotic past and future using a touching story of her great uncle, along with facts such as “1 out of every 6 recipients of new hip joints would die” without antibiotics. She also discussed this article on yesterday’s CBC “Sunday Edition” radio broadcast (audio available here).

As if we need other things to add to our phobia lists, there’s a new case-report published in the Journal of Antimicrobial Chemotherapy of an elderly Spanish woman with chronic renal disease and recurrent urinary tract infections. She initially presented with pyelonephritis caused by a susceptible Escherichia coli. However, after 1 week of therapy she developed sepsis and renal failure that was unresponsive to meropenem and died. Multi-drug resistant E. coli was isolated, which was resistant to all tested antibiotics except fosfomycin, tigecycline and tetracycline.

Further analysis identified numerous resistance and virulence genes. Importantly, the authors state that this is “the first report of the co-production of KPC-3, VIM-1, SHV-12, OXA-9 and CMY-2 in a unique clinical multi-resistant E. coli isolate.”

With air pollution, it’s risky to breathe and with water pollution it’s risky to drink. I guess now it’s risky to pee.

Eli N. Perencevich, MD, ACP Member, is an infectious disease physician and epidemiologist in Iowa City, Iowa, who studies methods to halt the spread of resistant bacteria in our hospitals (including novel ways to get everyone to wash their hands). This post originally appeared at the blog Controversies in Hospital Infection Prevention.