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<p class="MsoNormal"><span style="font-size:12.0pt;color:#0000CC"><a href="https://www.washingtonpost.com/news/to-your-health/wp/2016/05/26/the-superbug-that-doctors-have-been-dreading-just-reached-the-u-s/?wpisrc=al_alert-COMBO-exclusive%252Bnational">https://www.washingtonpost.com/news/to-your-health/wp/2016/05/26/the-superbug-that-doctors-have-been-dreading-just-reached-the-u-s/?wpisrc=al_alert-COMBO-exclusive%252Bnational</a><o:p></o:p></span></p>
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<b><span lang="EN" style="font-size:40.5pt;font-family:FranklinITCProBold;color:#333333">The superbug that doctors have been dreading just reached the U.S.<o:p></o:p></span></b></p>
<p class="MsoNormal" style="line-height:15.0pt;background:#F7F7F7"><span lang="EN" style="font-size:12.0pt">By
<a href="http://www.washingtonpost.com/people/lena-h-sun"><span style="color:#2E6D9D;text-decoration:none">Lena H. Sun</span></a> and
<a href="http://www.washingtonpost.com/people/brady-dennis"><span style="color:#2E6D9D;text-decoration:none">Brady Dennis</span></a>
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height:15.0pt;background:#F7F7F7"><span lang="EN" style="font-size:12.0pt"><a href="http://www.washingtonpost.com/news/to-your-health"><span style="color:#2E6D9D;text-decoration:none">To Your Health</span></a><o:p></o:p></span></p>
<p class="MsoNormal" style="line-height:15.0pt;background:#F7F7F7"><span lang="EN" style="font-size:12.0pt;color:#B2B2B2">May 26 at 2:27 PM</span><span lang="EN" style="font-size:12.0pt">
<o:p></o:p></span></p>
<p class="MsoNormal" style="line-height:15.0pt;background:#F7F7F7"><a name="f151b2590b"></a><span style="font-size:12.0pt"><img border="0" width="628" height="425" id="Picture_x0020_1" src="cid:image001.jpg@01D1B764.96D09640" alt="https://img.washingtonpost.com/wp-apps/imrs.php?src=https://img.washingtonpost.com/rf/image_908w/2010-2019/WashingtonPost/2013/09/19/Editorial-Opinion/Images/2013-09-16T210838Z_01_TOR115_RTRIDSP_3_HEALTH-SUPERBUGS.jpg&w=1484"></span><span lang="EN" style="font-size:12.0pt"><br>
<span style="color:#6E6E6E">CRE, a family of bacteria pictured, is considered one of the deadliest superbugs because it causes infections that are often resistant to most antibiotics. (Reuters/CDC)</span>
<o:p></o:p></span></p>
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<span lang="EN" style="font-size:12.0pt">For the first time, researchers have found a person in the United States carrying a bacteria resistant to antibiotics of last resort, an alarming development that the top U.S. public health official says could mean "the
 end of the road" for antibiotics.<o:p></o:p></span></p>
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<span lang="EN" style="font-size:12.0pt">The antibiotic-resistant strain was found last month in the urine of a 49-year-old Pennsylvania woman. Department of Defense researchers determined that her infection involved a strain of E. coli resistant to the antibiotic
 colistin, according to a study<a href="http://aac.asm.org/content/early/2016/05/25/AAC.01103-16.full.pdf+html"><span style="color:#2E6D9D;text-decoration:none"> published Thursday</span></a> in Antimicrobial Agents and Chemotherapy, a publication of the American
 Society for Microbiology. The authors wrote that the discovery "heralds the emergence of a truly pan-drug resistant bacteria."<o:p></o:p></span></p>
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<span lang="EN" style="font-size:12.0pt">Colistin is the antibiotic of last resort for particularly dangerous types of superbugs, including a family of bacteria known as CRE, which health officials have dubbed "nightmare bacteria." In some instances, these
 superbugs kill up to 50 percent of patients who become infected. The Centers for Disease Control and Prevention has called CRE among the country's most urgent public health threats.<o:p></o:p></span></p>
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<span lang="EN" style="font-size:12.0pt">It's the first time this colistin-resistant strain has been found in a person in the United States. Last November, public health officials around the globe reacted with alarm when Chinese and British researchers reported
 finding the colistin-resistant strain in pigs, raw pork meat and in a small number of people in China. The deadly strain was later discovered in Europe and elsewhere.<o:p></o:p></span></p>
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<span lang="EN" style="font-size:12.0pt">“It basically shows us that the end of the road isn’t very far away for antibiotics -- that we may be in a situation where we have patients in our intensive-care units, or patients getting urinary tract infections for
 which we do not have antibiotics,” CDC Director Tom Frieden in an interview Thursday.<o:p></o:p></span></p>
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<span lang="EN" style="font-size:12.0pt">“I’ve been there for TB patients. I’ve cared for patients for whom there are no drugs left. It is a feeling of such horror and helplessness,” Frieden added. “This is not where we need to be.”<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom:11.25pt;line-height:21.0pt;background:#F7F7F7">
<span lang="EN" style="font-size:12.0pt">CDC officials are working with Pennsylvania health authorities to interview the patient and family to identify how she may have contracted the bacteria, including reviewing recent hospitalizations and other healthcare
 exposures. CDC hopes to screen the patient and other contacts to see if others might be carrying the organism. Local and state health departments will also be collecting cultures as part of the investigation.<o:p></o:p></span></p>
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<span lang="EN" style="font-size:12.0pt">Scientists and public health officials have long warned that if the resistant bacteria continue to spread, it could seriously limit available treatment options. Routine operations could become deadly. Minor infections
 could become life-threatening crises. Pneumonia could be more and more difficult to treat.<o:p></o:p></span></p>
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<span lang="EN" style="font-size:12.0pt">Already, doctors had been forced to rely on colistin as a last-line defense against antibiotic-resistant bacteria. The drug is hardly ideal. It is more than half a century old and can cause serious damage to a patient’s
 kidneys. And yet, because doctors have run out of weapons to fight a growing number of infections that evade more modern antibiotics, it has become a critical tool in fighting off some of the most tenacious infections.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom:11.25pt;line-height:21.0pt;background:#F7F7F7">
<span lang="EN" style="font-size:12.0pt">Bacteria develop antibiotic resistance in two ways. Many acquire mutations in their own genomes that allow them to withstand antibiotics, although that ability can't be shared with pathogens outside their own family.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom:11.25pt;line-height:21.0pt;background:#F7F7F7">
<span lang="EN" style="font-size:12.0pt">Other bacteria rely on a shortcut: they get infected with something called a plasmid, a small piece of DNA, carrying a gene for antibiotic resistance. That makes resistance genes more dangerous because plasmids can make
 copies of themselves and transfer the genes they carry to other bugs within the same family as well as jump to other families of bacteria, which can then "catch" the resistance directly without having to develop it through evolution.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom:11.25pt;line-height:21.0pt;background:#F7F7F7">
<span lang="EN" style="font-size:12.0pt">The colistin-resistant E. coli found in the Pennsylvania woman has this type of resistance gene.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom:11.25pt;line-height:21.0pt;background:#F7F7F7">
<span lang="EN" style="font-size:12.0pt"><o:p> </o:p></span></p>
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<span lang="EN" style="font-size:12.0pt">Read more:<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom:11.25pt;line-height:21.0pt;background:#F7F7F7">
<span lang="EN" style="font-size:12.0pt"><a href="https://www.washingtonpost.com/news/to-your-health/wp/2015/12/03/superbug-known-as-phantom-menace-on-the-rise-in-u-s/"><span style="color:#2E6D9D;text-decoration:none">Superbug known as 'phantom menace" on the
 rise in the U.S.</span></a><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-bottom:11.25pt;line-height:21.0pt;background:#F7F7F7">
<span lang="EN" style="font-size:12.0pt"><a href="https://www.washingtonpost.com/news/to-your-health/wp/2016/05/03/1-in-3-antibiotics-prescribed-in-u-s-are-unnecessary-major-study-finds/"><span style="color:#2E6D9D;text-decoration:none">Big factor in antibiotic
 resistance: 1 in 3 antibiotics prescribed are unnecessary</span></a><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;color:#0000CC"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;color:#0000CC"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:9.0pt;color:#000099">Deborah L. DeBiasi<br>
<b>Email:   <a href="mailto:Deborah.DeBiasi@deq.virginia.gov"><span style="color:#000099">Deborah.DeBiasi@deq.virginia.gov</span></a><i><br>
</i></b>WEB site address:  <a href="http://www.deq.virginia.gov/"><span style="color:#000099">www.deq.virginia.gov</span></a><br>
Virginia Department of Environmental Quality<br>
Office of Water Permits <br>
Industrial Pretreatment/Whole Effluent Toxicity (WET) Program<br>
PPCPs, EDCs, and Microconstituents<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:9.0pt;color:#000099"><a href="http://www.deq.virginia.gov/Programs/Water/PermittingCompliance/PollutionDischargeElimination/Microconstituents.aspx"><span style="color:#000099">http://www.deq.virginia.gov/Programs/Water/PermittingCompliance/PollutionDischargeElimination/Microconstituents.aspx</span></a><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:9.0pt;color:#000099">Mail:          P.O. Box 1105, Richmond, VA  23218<br>
Location:  629 E. Main Street, Richmond, VA  23219<br>
PH:         804-698-4028      FAX:      804-698-4032</span><span style="font-size:9.0pt;color:navy"><o:p></o:p></span></p>
<p class="MsoNormal"><o:p> </o:p></p>
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