A patient at Cheyenne Regional Medical Center was diagnosed with an “extremely rare” antibiotic-resistant infection, according to the state Department of Health, the first time the infection has been confirmed in Wyoming.
The patient, whose identity was not released by the Health Department, is a Cheyenne resident who was ill with an enterobacteriaceae-related infection, a type of bacteria that includes E. coli and salmonella. The infectious bacteria also contained a rare antibiotic-resistant gene known as MCR-1, which is resistant to the class of drugs that are considered last-resort antibiotics but is not completely immune to treatment. Hospital officials discovered it in a urine test of the patient, said Tracy Garcia, the chief nursing officer.
This particular gene was only recently discovered globally, in China in 2015. It was first discovered in the U.S. in 2016, in Pennsylvania. It has since appeared in several American states, a group that now includes Wyoming. Testing by the state and by the Centers for Disease Control and Prevention confirmed the gene was present in the patient’s infection.
“When bacteria become antibiotic-resistant, then certain categories of antibiotic medicines will not work to kill the bacteria to treat an infection,” Dr. Alexia Harrist, the state’s health officer and epidemiologist, said in a press release.
Kim Deti, a spokeswoman for the Health Department, said it does not appear that the patient contracted the infection at Cheyenne Regional and said Wyomingites should not be worried.
Hospital officials reiterated that feeling at a press conference Wednesday. They said it was unlikely they would ever know the origin of the infection and that they were taking precautions to ensure it doesn’t spread. But, they said, it was likely isolated to this individual patient.
Dr. Hoo Feng Choo, the hospital’s infection disease specialist, said that when the Pennsylvania case was confirmed, health officials there tested specimens from more than 100 people close to the ill person, and none showed traces of the gene that caused the resistance.
The patient has since responded to a different antibiotic treatment and is doing better, health officials said, though they declined to provide any more specifics, citing patient privacy.
“We are working closely with the hospital to prevent the spread of this bacteria,” Harrist said in the press release. “Although this finding is unexpected and something we are taking seriously, we believe the contact precautions already in place at the hospital have likely limited the potential spread of the bacteria.”
“I know there’s a growing concern in the health care world about the growth in antibiotic resistance,” Deti told the Star-Tribune. “The fact that this one is involved in that particular class of last-resort medications, that adds to the significance of this gene.”
In a September 2018 post about the gene, the CDC warned that the spread of antibiotic-resistance infections have the “potential to severely impact our ability to provide medical treatment.”
“Although there is no immediate threat to the public, the discovery of mcr -1 (the infection found in the Wyoming patient) vividly illustrates the many domestic and global challenges facing us as we work to slow the spread of antibiotic resistance and improve antibiotic use,” CDC officials wrote.
Choo said the case illustrates the need to be careful with the prescription of antibiotics, both for humans and animals. The CDC warns against using antibiotics to treat viral infections like the flu or common cold, for instance, as the drugs will have no effect and can contribute to making bacteria resistant. Properly using antibiotics — like completing a cycle as prescribed — help avoid making the organisms resistant to medication.
“Overuse and misuse of antibiotics allows the development of antibiotic-resistant bacteria,” the CDC wrote. “Every time a person takes antibiotics, sensitive bacteria (bacteria that antibiotics can still attack) are killed, but resistant bacteria are left to grow and multiply. This is how repeated use of antibiotics can increase the number of drug-resistant bacteria.”