Last week, you might have read about carbapenem-resistant ‘superbugs’ (actually, these are pretty ordinary bacteria except that they’re resistant to just about everything we can throw at them) due to the recent study detailing an outbreak at the NIH. I’ve written about these organisms before, so I won’t rehash the biology.
(full disclosure: I am currently involved with an NIAID-funded project to sequence isolates (historical and prospectively isolated) from multiple hospitals.)
Right now, the only good news is that these infections are still very rare–on the East Coast, outside of New York City, large hospitals are maybe seeing one per month (in some NYC hospitals, they’re more common). While they are spreading, they are still essentially anecdotal events. Sometimes, they’re associated with an outbreak (i.e., more than one patient), other times, they appear to be ‘one offs.’ What is disconcerting is that, increasingly, these isolates can’t be traced back to New York. And as Maryn McKenna notes, because these organisms are commensals (part of the normal gut flora), they can be carried by asymptomatic people.
Right now, I think we can still contain this organism if hospitals practice really rigorous infection control (isolating patients, testing surfaces, and screening workers), although Klebsiella pneumoniae is a very hardy organism (at the NIH hospital, it was found in the sink drains). Unfortunately, I don’t think there is the political will or the public health infrastructure to respond adequately to this crisis.
Cataloging the apocalypse is getting really old.