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Ringing the Warning Bell: Colistin-Resistant Klebsiella http://apocadocs.com/s.pl?1313586227
In all the latest bad news about bacteria becoming highly resistant -- through carbapenem resistance, or the "Indian supergene" NDM-1 -- there has been one hopeful thread: All of the organisms have remained susceptible to one very old, little-used drug called colistin.
That might be about to change. Which would be very, very bad news.
Writing in a recent issue of Clinical Infectious Diseases, faculty from the University of Pittsburgh say they saw five patients last year with colistin-resistant Klebsiella pneumoniae, a Gram-negative bacterium that is a frequent cause of very serious hospital infections and that has already become resistant to multiple classes of drugs....
There are a couple of observations that can be teased out of these cases.
The first is that these infections tend to happen to people who are already very sick: in need of a transplant; or having gotten a transplant, and on immune system-suppressing drugs; or with traumatic injury. They are people who would have been at risk for hospital-acquired infections.
The second is how these unexpectedly resistant hospital infections complicate the course of an already-sick patient. The victims in this outbreak were in the hospital from six weeks, in the shortest course, to six months in the longest.
The third is that some treatment is thankfully still possible. The organism -- which was identical in four of the patients and negligibly different in the fifth -- still responded to tigecycline, a relatively new drug. But in the table of susceptibility and resistance published in the journal, tigecycline was manifestly the only drug that still worked.
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