'Nightmare bacteria' superbug found for first time in US

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Long-Feared Drug-Resistant Superbug Found for First Time in U.S.

A drug-resistant "superbug" that doctors have been dreading has shown up in the U.S. for the first time, researchers reported Thursday.

The bacteria has genetic changes that make it resistant to a last-ditch antibiotic called colistin and while it had been seen in Europe and China, no one in the U.S. had been seen with it before.

It doesn't spell doom just yet.

The mutant E. coli germ was found in a Pennsylvania woman with symptoms of a urinary tract infection, but it does not appear to be spreading at epidemic proportions. And it was susceptible to other antibiotics, so the patient was not left without any hope.

Related: Superbug outbreak at UCLA:

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video at front: Superbug Outbreak, UCLA Medical Center, Cedars-Sinai
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'Nightmare bacteria' superbug found for first time in US
The manufacturer of the endoscope involved in two superbug deaths at UCLA never received permission from the Food and Drug Administration.
This illustration released by the Centers for Disease Control depicts a three-dimensional (3D) computer-generated image of a group of carbapenem-resistant Enterobacteriaceae bacteria. The artistic recreation was based upon scanning electron micrographic imagery. A potentially deadly "superbug" resistant to antibiotics infected seven patients, including two who died, and more than 100 others were exposed at a Southern California hospital through contaminated medical instruments, UCLA reported Wednesday Feb. 18, 2015. (AP Photo/Centers for Disease Control)
FILE - This undated file photo provided by the U.S. Food and Drug Administration shows the tip of an endoscopic retrograde cholangiopancreatography (ERCP) duodenoscope, attached to a long tube, not shown. A patient has sued the maker of the medical scope linked to the outbreak of a superbug at Ronald Reagan UCLA Medical Center in Los Angeles. (AP Photo/U.S. Food and Drug Administration, File)
A pedestrain approaches an entrance to Cedars-Sinai Medical Center in Los Angeles on September 7, 2012 in California, where veteran French rocker Johnny Hallyday underwent examinations this week following a health scare in the Caribbean. Hallyday's manager Sebastien Farran said the “general” tests on the 69-year-old singer were due to be finished Friday” with Hallyday released from hospital. AFP PHOTO / Frederic J. BROWN (Photo credit should read FREDERIC J. BROWN/AFP/GettyImages)
LOS ANGELES, CA - JUNE 15: General view of the Cedars-Sinai Medical Center where Kim Kardashian and Kanye West welcomed a baby girl on June 15, 2013 in Los Angeles, California. (Photo by JB Lacroix/WireImage)
A pedestrain crosses a street at Cedars-Sinai Medical Center in Los Angeles on September 7, 2012 in California, where veteran French rocker Johnny Hallyday underwent examinations this week following a health scare in the Caribbean. Hallyday's manager Sebastien Farran said the “general” tests on the 69-year-old singer were due to be finished Friday” with Hallyday released from hospital. AFP PHOTO / Frederic J. BROWN (Photo credit should read FREDERIC J. BROWN/AFP/GettyImages)
WESTWOOD, CA - FEBRUARY 18: The exterior of the Ronald Reagan UCLA Medical Center is shown February 18, 2015 in Westwood California. (Photo by Francine Orr/Los Angeles Times via Getty Images)
WESTWOOD, CA - FEBRUARY 18: The exterior of the Ronald Reagan UCLA Medical Center is shown February 18, 2015 in Westwood California. (Photo by Francine Orr/Los Angeles Times via Getty Images)
7 Infected, More Than 100 Exposed To Potentially Fatal "Superbug" At UCLA Hospital: http://t.co/1hscksipJk http://t.co/mCQ3lsx3TG
'Superbug' may have caused two deaths at UCLA hospital http://t.co/gFElaAgUrI #sanfrancisco http://t.co/RLRkLuY3gQ
More than 100 patients might have been exposed to a deadly bacteria known as CRE at UCLA Ronald Reagan Medical Center.
Dr. Zachary Rubin, medical director of clinical epidemiology and infection prevention at the Ronald Reagan UCLA Medical Center, right, takes questions from the media in Los Angeles Thursday, Feb. 19, 2015. Los Angeles County health officials say a "superbug" bacterial outbreak at a local hospital doesn't pose any threat to public health. At left, Dr. Robert Cherry, chief medical and quality officer, UCLA Health System, and Dr. Benjamin Schwartz, deputy chief of the Acute Communicable Disease Control Program at the county Department of Public Health, middle. (AP Photo/Damian Dovarganes)
Dr. Zachary Rubin, medical director of clinical epidemiology and infection prevention at the Ronald Reagan UCLA Medical Center, left, takes questions from the media in Los Angeles Thursday, Feb. 19, 2015. Los Angeles County health officials say a "superbug" bacterial outbreak at a local hospital doesn't pose any threat to public health. A day earlier, UCLA officials said nearly 180 patients at Ronald Reagan UCLA Medical Center had been exposed to antibiotic-resistant bacteria called CRE. Seven of them got the infection and two of those people have died. (AP Photo/Damian Dovarganes)
UCLA medical officials take questions from the media outside the Ronald Reagan UCLA Medical Center in Los Angeles Thursday, Feb. 19, 2015. A day earlier, UCLA officials said nearly 180 patients at Ronald Reagan UCLA Medical Center had been exposed to antibiotic-resistant bacteria called CRE. Seven of them got the infection and two of those people have died. (AP Photo/Damian Dovarganes)
LOS ANGELES, CA - JUNE 15: General view of the Cedars-Sinai Medical Center where Kim Kardashian and Kanye West welcomed a baby girl on June 15, 2013 in Los Angeles, California. (Photo by JB Lacroix/WireImage)
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What's worrying is the gene that made the E. coli drug-resistant. It's called mcr-1, and it is passed from one bacteria to another. It sits on a piece of material called a plasmid, which makes it easy for one species of bacteria to pass it along to another species of bacteria.

Scientist fear an E. coli bacteria with the mcr-1 gene could pass it to another superbug with other mutations-- creating a truly super-superbug that resists all known antibiotics.

If such a superbug spread, it would take the world back to a time when there were no antibiotics, says Dr. Tom Frieden, director of the Centers for Disease Control and Prevention.

"It is the end of the road for antibiotics unless we act urgently," he said.

This discovery suggests the drug-resistance gene has been here in the U.S., flying under the radar.

"This patient hadn't traveled," Frieden said.

Patrick McGann and colleagues at the Walter Reed Army Institute of Research just outside Washington D.C. have been looking at samples from patients, keeping an eye out for bacteria with the mutation.

They reported Thursday they found one. The sample is E. coli bacteria with mcr-1.

"I was extremely surprised when it came up positive," McGann told NBC News. It was the very first sample his lab tested in the new search for the gene.

This little stretch of DNA, which bacteria can swap easily among themselves, gives them the ability to fight off the effects of colistin.

"It was an old antibiotic, but it was the only one left for what I called nightmare bacteria, carbapenem-resistant enterobacteriaceae, or CRE," Frieden said.

Luckily, this particular bacteria was not also resistant to carbapenems. But it was resistant to several other classes of antibiotics, including fluoroquinolones, and the fact that it had the mcr-1 gene raises alarm bells.

"To the best of our knowledge, this is the first report of mcr-1 in the USA," the Walter Reed researchers wrote in their report, published in the journal Antimicrobial Agents and Chemotherapy.

They've only been looking for this particular mutation for three weeks, so they said they're not sure just how widespread it is.

"We know now that the more we look, the more we are going to find," Frieden said in a speech at the National Press Club in Washington. "The more we look at drug resistance, the more concerned we become."

Later Thursday, the health and Human Services Department said scientists had also found the mcr-1 mutation in a sample from a pig. "Out of 949 animal samples screened so far, one strain of colistin-resistant E. coli was found in a pig intestinal sample," it said in a statement.

"The DNA sequence of this isolate revealed that the strain contained the mcr-1 gene on a plasmid. The scientists also determined that the mcr-1 carrying colistin-resistant E. coli is resistant to other antibiotics including ampicillin, streptomycin, sulfisoxazole, and tetracycline."

CDC has been warning for years about the threat of drug-resistant bacteria. It's been urging drug companies to develop new antibiotics, and asking people to make better use of the antibiotics now available so that more superbugs do not evolve.

"The medicine cabinet is empty for some patients," Frieden said.

Related: Chipotle closings over E. coli:

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Chipotle closings because of E.coli
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'Nightmare bacteria' superbug found for first time in US
Passers-by walk near a closed Chipotle restaurant on Monday, Dec. 7, 2015, in the Cleveland Circle neighborhood of Boston. Chipotle said late Monday that it closed the restaurant after several students at Boston College, including members of the menâs basketball team, reported âgastrointestinal symptomsâ after eating at the chain. The school said it was working with local health officials to determine the cause of the illness. (AP Photo/Steven Senne)
A sign is posted on the door to a Chipotle restaurant, Monday, Dec. 7, 2015, in the Cleveland Circle neighborhood of Boston. Chipotle said late Monday that it closed the restaurant after several students at Boston College, including members of the menâs basketball team, reported âgastrointestinal symptomsâ after eating at the chain. The school said it was working with local health officials to determine the cause of the illness. (AP Photo/Steven Senne)
A customer leaves a Chipotle restaurant in Seattle as the company started to reopen the outlets closed because of an E. coli outbreak in the Pacific Northwest, Wednesday, Nov. 11, 2015. (AP Photo/Donna Blankinship)
Customers leave a Chipotle restaurant with food in Portland, Ore., Wednesday, Nov. 11, 2015. Chipotle started reopening its restaurants in the Pacific Northwest on Wednesday after an E. coli outbreak sickened about 45 people, a high-profile example of foodborne illnesses that are more common than the public realizes, health experts say. Forty-three outposts of the Mexican food chain in Washington state and the Portland, Oregon, area were closed at the end of October because of the outbreak that hospitalized more than a dozen people. The first restaurants opened for lunch Wednesday. (AP Photo/Don Ryan)
A customer enjoys lunch at a Chipotle restaurant in Portland, Ore., Wednesday, Nov. 11, 2015. Chipotle started reopening its restaurants in the Pacific Northwest on Wednesday after an E. coli outbreak sickened about 45 people, a high-profile example of foodborne illnesses that are more common than the public realizes, health experts say. Forty-three outposts of the Mexican food chain in Washington state and the Portland, Oregon, area were closed at the end of October because of the outbreak that hospitalized more than a dozen people. The first restaurants opened for lunch Wednesday. (AP Photo/Don Ryan)
Rosanna Fleming enters a Chipotle restaurant for lunch as another customer enters a second door in the background in Portland, Ore., Wednesday, Nov. 11, 2015. Chipotle started reopening its restaurants in the Pacific Northwest on Wednesday after an E. coli outbreak sickened about 45 people, a high-profile example of foodborne illnesses that are more common than the public realizes, health experts say. Forty-three outposts of the Mexican food chain in Washington state and the Portland, Oregon, area were closed at the end of October because of the outbreak that hospitalized more than a dozen people. The first restaurants opened for lunch Wednesday. (AP Photo/Don Ryan)
Workers clean inside a still-closed Chipotle restaurant Monday, Nov. 9, 2015, in Seattle. Health officials in Washington and Oregon have said that more than three dozen people have gotten sick with E. coli in an outbreak linked to Chipotle restaurants in the two states. More than 40 Chipotle restaurants remain closed in Washington state and the Portland area while authorities search for the cause. (AP Photo/Elaine Thompson)
FILE - In this Nov. 9, 2015, file photo, pedestrians walk past a still-closed Chipotle restaurant in Seattle. An outbreak of E. coli that originated in the Pacific Northwest has spread south and east and has now infected people in six states. New cases have been reported in California, New York and Ohio, the Centers for Disease Control and Prevention said Friday, Nov. 20, 2015. (AP Photo/Elaine Thompson, File)
A worker sits at a counter inside a still-closed Chipotle restaurant Monday, Nov. 9, 2015, in Seattle. Health officials in Washington and Oregon have said that more than three dozen people have gotten sick with E. coli in an outbreak linked to Chipotle restaurants in the two states. More than 40 Chipotle restaurants remain closed in Washington state and the Portland area while authorities search for the cause. (AP Photo/Elaine Thompson)
Workers clean inside a still-closed Chipotle restaurant Monday, Nov. 9, 2015, in Seattle. Health officials in Washington and Oregon have said that more than three dozen people have gotten sick with E. coli in an outbreak linked to Chipotle restaurants in the two states. More than 40 Chipotle restaurants remain closed in Washington state and the Portland area while authorities search for the cause. (AP Photo/Elaine Thompson)
A closed Chipotle restaurant is shown, Tuesday, Nov. 3, 2015, in Federal Way, Wash. Chipotle closed 43 of its Pacific Northwest locations after the chain's third foodborne illness this year sickened about two dozen people. (AP Photo/Ted S. Warren)
A pedestrian, right, walks past a closed Chipotle restaurant Monday, Nov. 2, 2015, in Seattle. An E. coli outbreak linked to Chipotle restaurants in Washington state and Oregon has sickened nearly two dozen people in the third outbreak of foodborne illness at the popular chain this year. Cases of the bacterial illness were traced to six of the fast-casual Mexican food restaurants, but the company voluntarily closed down 43 of its locations in the two states as a precaution. (AP Photo/Elaine Thompson)
A sign posted on the door of a Chipotle restaurant in Portland, Ore. reads that the location is "temporarily closed due to a supply chain issue," on Monday, Nov. 2, 2015. An E. coli outbreak linked to Chipotle restaurants in Washington state and Oregon has sickened nearly two dozen people in the third outbreak of food borne illness at the popular chain this year. (AP Photo/Don Ryan)
FILE - In this Nov. 2, 2015, file photo, a pedestrian walks past a closed Chipotle restaurant in Seattle. Washington state health officials say they have found no source for the E. coli outbreak related to Chipotle and the chain's Pacific Northwest restaurants could reopen later this week. Washington state epidemiologist Dr. Scott Lindquist says all the tests of food from Chipotle stores in Washington and Oregon came back negative for E. coli. (AP Photo/Elaine Thompson, File)
A woman talks on the phone as she stands in the kitchen area of a closed Chipotle restaurant, Monday, Nov. 2, 2015, in Seattle. An E. coli outbreak linked to Chipotle restaurants in Washington state and Oregon has sickened nearly two dozen people in the third outbreak of foodborne illness at the popular chain this year. Cases of the bacterial illness were traced to six of the fast-casual Mexican food restaurants, but the company voluntarily closed down 43 of its locations in the two states as a precaution. (AP Photo/Elaine Thompson)
Signage hangs from a closed Chipotle restaurant in Portland, Ore., Monday, Nov. 2, 2015. Chipotle voluntarily closed down 43 of its locations in Washington and the Portland area as a precaution after an E. coli outbreak linked to six of its restaurants in the two states has sickened nearly two dozen people. (AP Photo/Don Ryan)
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The CDC said it was working with the state health department in Pennsylvania to talk to the patient and her family to see how she may have been infected.

They'll also test others in the area who may have been in contact to see if they are carrying the bacteria - which may not necessarily cause illness or any symptoms at all.

"An urgent public health response is underway to contain and prevent potential spread of mcr-1," Walter Reed said in a statement.

Dr. David Hyun of the Pew Charitable Trusts, who follows the issue of drug-resistant bacteria, said details will be important. "I am very interested in finding out how did this patient do," he told NBC News. "What kind of treatment did she receive?"

There have been reports in other countries of patients with bacteria carrying mcr-1, but not many details of how they were cared for or whether other antibiotics cured their infections.

Related: Patients Carry Superbugs on Their Hands

Colistin, used to treat carbapenem-resistant Enterobacteriaceae or CRE, is an older antibiotic with some tough side-effects such as kidney damage. That's why it's only used as a last resort.

Hyun said in several of the international cases, people have been infected with CRE that carried the mcr-1 gene. That would leave them with few, if any, option for treatment. "If we are finding it in other countries, chances are that it's already happened in the United States as well," he said.

Bacteria develop resistance to drugs quickly. Even before penicillin was introduced in 1943, staphylococcus germs had genes that would have made them resistant to its effects.

Just nine years after tetracycline was introduced in 1950, a resistant strain of Shigella evolved. Methicillin-resistant Staphylococcus aureus (MRSA) evolved just two years after methicillin hit the market in 1960. The last new antibiotic to be introduced was ceftaroline, in 2010. It took just a year for the first staph germ to evolve that resisted its effects.

The CDC says more than two million people are infected by drug-resistant germs each year, and 23,000 die of their infections. The biggest killer by far in the U.S. is diarrhea-causing C. difficile.

Near-untreatable cases of diarrhea, sepsis, pneumonia and gonorrhea are infecting millions more globally, the World Health Organization says.

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