Antibiotic-Resistant Bugs in the 21st Century — A Clinical Super-Challenge

Abstract

In March 1942, a 33-year-old woman lay dying of streptococcal sepsis in a New Haven, Connecticut, hospital, and despite the best efforts of contemporary medical science, her doctors could not eradicate her bloodstream infection. Then they managed to obtain a small amount of a newly discovered substance called penicillin, which they cautiously injected into her. After repeated doses, her bloodstream was cleared of streptococci, she made a full recovery, and she went on to live to the age of 90.¹ Sixty-six years after her startling recovery, a report² described a 70-year-old man in San Francisco with endocarditis caused by vancomycin-resistant Enterococcus faecium (VRE). Despite the administration, for many days, of the best antibiotics available for combating VRE, physicians were unable to sterilize the patient's blood, and he died still bacteremic. We have come almost full circle and arrived at a point as frightening as the preantibiotic era: for patients infected with multidrug-resistant bacteria, there is no magic bullet.