Mechanisms yet understood

         Antibiotic resistance is ever on the rise. This year alone, I've seen a few pan-resistant organisms through testing. Several nights ago, a colleague showed me the result for a Pseudomonas that was also a carbapenemase producer according to the mCIM test.

         He wondered if it was common our molecular method couldn't detect the resistance marker. Well, the note on the report does suggest that could happen. After all, there exist mechanisms of resistance we have yet to discover.

         However, since neither of us was the one who performed the mCIM, we could only assume the performer(s) did it correctly. The downside of our large operation is that while we have many checks in place, we can't be 100% sure every step went down exactly as expected.

         The only thing left to do was to send the isolate to State Lab for them to perform more testing on the nature of this bacteria. Maybe the State Lab will find some novel resistant markers for this particular carbapenemase producer. Or, they'll find nothing special and we would have to revaluate our testing process.

         While it's fascinating to witness something yet discovered, it's also worrying. Carbapenems are some of the more potent drugs used to treat infections. Evolution is presenting challenges to our attempt to prolong life. In other words, the microbes are changing faster than we can keep up.

         I won't be bothered to follow up with this particular isolate unless the State report contains something interesting.

Posted with STEMGeeks