I'm not really all that mysterious

Pan-Resistant E. coli Caveat

Turns out, the E. coli isolated from a woman’s infected urine isn’t actually pan-resistant.

No, this isn’t the start of the antibiotic apocalypse, just bad reporting • 2016 May 26 • Beth Mole • Ars Technica

The misleading sentence is in the paper itself, though. “The recent discovery of a plasmid-borne colistin resistance gene, mcr-1, heralds the emergence of truly pan-drug resistant bacteria.” Pan-resistant would mean it’s not just resistant to colistin but every other antibiotic in our armamentarium: beta-lactams, cephalosporins, sulfa, tetracyclines, fluoroquinolones, aminoglycosides and colistin. But the resistance patterns of the isolated organism actually show that it’s still susceptible to amikacin, all the carbapenems, and nitrofurantoin. Don’t get me wrong, this is not great, since amikacin is nephrotoxic, and while nitrofurantoin is great for bladder infections, it’s not great for systemic infections.

I think what they’re trying to say is that finding mcr-1 on a plasmid makes it very likely that we’ll have pathogens with both carbapenem-resistance and colistin resistance soon enough.

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