A woman in Nevada was killed by a bacteria strain that had gained resistance to 26 different types of antibiotic, according to a new report from the United States’ Centres for Disease Control and Prevention (CDC). The tragic incident marks another step closer to a world in which bacterial infections are once again almost impossible to fight.

The woman, who was in her 70s and died last September, contracted the infection after breaking her leg in India, where there are more antibiotic resistant bacteria in the environment. Last year’s O’Neill review commissioned by the British government highlighted improving sanitation around the world as one key means of tackling the development of antibiotic resistant bacteria.

Reviewers from the Massachusetts Institute of Technology (MIT) said the woman’s death is a reminder of the pressing danger of antibiotic resistance, which is getting worse, though the issue has received comparatively little policy and media attention. The UK’s Chief Medical Officer Prof Dame Sally Davies has said antibiotic resistance poses as great a threat to humanity as climate change and the O’Neill review outlined a raft of measures to be taken immediately to avoid entering a new post-antibiotic age, though there have still been no concrete regulations introduced to preserve antibiotics and no moves to incentivise drug companies to develop new antibiotics.

The Nevada woman had been infected with bacteria called Klebsiella pneumoniae, which had evolved resistance to multiple drugs. This bacteria also carried a mutation known as NDM-1. The NDM-1 mutation made the bacteria resistant to even last-resort treatments. Though CDC testing revealed that the bacteria were susceptible to one antibiotic - fosfomycin - this isn’t licensed for intravenous use in the United States, so the report concluded that no available treatments could have saved the woman.

Commenting on the case, Prof. Nigel Brown, a spokesperson for the Microbiology Society, said,  “Microbiologists have been concerned for a number of years about the rise of antibiotic resistance in bacteria.  This sad case of a fatal infection acquired overseas, in which the pathogen was resistant to 26 different antibiotics, is a wake-up call for the isolation and development of new classes of antibiotic. There is also a need for international agreements on the use of antibiotics; too many countries allow medically-important antibiotics to be self-prescribed or to be used in agriculture.”

Prof. Nick Thomson, leader of the bacterial genomics and evolution group at the Wellcome Trust Sanger Institute, added, “Although this type of bacterium is not common it is not unique either and the current trajectory for this bacterium is to become more and more resistant to treatments. The report highlights international travel and treatment overseas as a feature in the introduction of this pan-resistant isolate into the USA. Since we live in such an interconnected society, this is important because this isolate represents a truly untreatable infection which limits treatment options to principally patient management to prevent ongoing transmission.”

Earlier this month, the Alliance to Save Our Antibiotics - which is calling for drastic measures to prevent the development of antibiotic resistance that could threaten human medicine in agriculture - clashed with the National Pig Association (NPA) after Alliance campaigner Colin Nunan gave an interview to Radio 4’s Farming Today programme at the Oxford Real Farming Conference. The Alliance spokesperson unfavourably compared action being taken by the UK pig industry to moves to cut antibiotics use in poultry.

Nunan warned that pig farming accounts for most of the UK’s farm antibiotics use, and that the current level of antibiotic use in British pigs is approximately five times higher per pig than in pigs in Denmark or the Netherlands. The poultry industry has begun to voluntarily ban routine preventative use of antibiotics, but the pig industry has only begun collecting data to benchmark use in the sector.