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Death of Delhi-Returned US Woman with High Resistant Bacterial Infection Evokes Concern

An American woman who returned from New Delhi after she was allegedly infected by a superbug finally succumbed to the highly resistant bacterial infection called Klebsiella Pneumoniae that was found to have resisted 14 known anti-bacterial drugs on her during the treatment. Irony was that a treatment called fosfomycin, approved in Europe, was not approved in the US still.

The 70-year-olod woman was diagnosed with carbapenem-resistant Enterobacteriaceae (CRE), a fatal multidrug-resistant organism on her return from Delhi and was admitted to an acute care hospital. The CRE, identified as Klebsiella pneumoniae from her wound specimen was sent to the US Centres for Disease Control (CDC) where test confirmed the presence of New Delhi metallo-beta-lactamase (NDM-1).

In antimicrobial testing, it was shown that the isolate was resistant to 26 different antibiotics, including all aminoglycosides and polymixins, which is given as a last-resort antibiotics. With no treatment options, the US woman died in September last year. Prior to her return, she lived in Delhi for two years and had been hospitalised at least three times for right femur fracture and once for hip fracture.

NDM-1 was originally identified in 2009 in a Swedish patient who had been hospitalised in India and research showed that the infection could spread in the hospital environment. It has been described by the World Health Organization as "an urgent threat to human health."

Prof. Laura Piddock from the University of Birmingham, said there is a need to be flexible to use antibiotics licensed for use in other countries to avoid repetition of the death of the Delhi-returned woman.

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