Pan-Resistant Bacteria & The Crisis It Could Bring

I read this downright frightening article the other day:

A superbug resistant to every available antibiotic in the U.S. kills Nevada woman

The article was reproduced on PBS with permission from STAT News where it was first published.

Here's the original article:

A Nevada Woman dies of a superbug resistant to every available antibiotic in the US

Why this is terrifying for everybody

Nearly a century ago, before the advent of antibiotics – Penicillin being the first true antibiotic – it was commonplace for people to die of bacterial infections. Bacterial infections can wreak havoc by themselves, but most bacterial infections are treatable with antibiotics. Until they become drug-resistant. Then they're no longer "bugs" – they become "superbugs." "Superbugs" is just a scary term for bugs that are difficult to fight with most antibiotics.

But until recently, it wasn't common, in the US at least, for people to culture pan-resistant bacteria. It's happened before, but the news that a woman died in September because of a bacteria that could fend off all drugs available in the US is alarming.

The video below gives a nice explanation of superbugs. The video does an excellent job of explaining how and why superbugs developed.

The video above has been provided by HYACINTH EMPINADO/STAT from It is specifically from the original site that posted the article. 

Why this is particularly terrifying to people with CF

Cystic fibrosis, as understood by people who are familiar with it, is a genetic disease that causes thicker mucus in the lungs. Due to this, as they understand, infection is more common.

To be clear, most patients with cystic fibrosis always culture numerous types of bacteria in their lungs and sinuses. Different external factors – missing treatments, missing medication, smoking cigarettes are all examples – can trigger an exacerbation, which is basically just the bacteria in the lungs that have already made a home flaring up and causing more harm than usual. 

Here's where things for doctors and patients become tricky.

Oftentimes, it's hard to determine which specific strain of bacteria is causing the exacerbation. There are two major types of bacteria – gram-negative and gram-positive – which have different cellular structures. For this reason, they're treated with different classes of antibiotics. Some antibiotics work by disrupting the materials that form the cellular walls of bacteria, others disrupt protein synthesis, among plenty of other mechanisms.

Unfortunately for all people, especially people with CF where lung infections are always a lingering possibility, bacteria evolve. Quickly. Usually much more quickly than we can develop drugs.

In today's research world, the funding just isn't there for new antibiotic development. The primary focus of CF fundraising is on other drug classes, specifically the most promising: CFTR modulators. I'll write about these in a different post. I also want to acknowledge that I believe that class to be the most crucial and deserving of the funding. 

Back to the topic of drug resistance: after trying all possible drugs and drug combinations, CF exacerbations usually progress to the point of no return. The lone remaining option for most CF patients who are eligible is a double lung transplant. The reality of transplants is that post-operative care is necessary for the rest of life and is basically like inheriting a separate, but in many ways equally as bad, condition.

What you can do to combat drug resistance

The most important thing anybody – people with CF and people without – can do is to follow the orders of the medications carefully and accurately. Don't miss doses, don't stop the treatment before the prescribed course is completed, don't pressure your doctor to prescribe antibiotics for viral infections, don't take antibiotics when you're unsure of the cause or when you've not been advised by a physician. 

An issue with drug resistance is the vast ignorance of patients. The truth is most people don't understand antibiotics; they don't understand why they're taking them, they don't understand how they work, and they're possible completely unaware of drug resistance. 

The responsibility is on both the patient and the doctor. The patient must do her part to understand the implications of their sickness and course of treatment; the doctor must thoroughly communicate the risks of not correctly following the course of treatment and why the specific course of treatment is even being applied.

In future posts, I'll write about CF care, normal care, healthcare in general, and more detailed scientific and medical articles. For now, I'll leave this post with an incredible demonstration of how bacteria evolve at a rapid rate.

In a creative stroke inspired by Hollywood wizardry, scientists from the Kishony Lab at HMS and Technion ( have designed a simple way to observe how bacteria move as they become impervious to drugs. The experiments are thought to provide the first large-scale glimpse of the maneuvers of bacteria as they encounter increasingly higher doses of antibiotics and adapt to survive-and thrive-in them. [Caption and video provided by Harvard Medical School.]

Everybody – CF patients, friends, and family – please take your medication as advised. It's vital for everybody.