This week the blog was supposed to be a continuance of our Disinfection Dysfunction campaign, but then a CDC Health Advisory came out and it seems a bit more critical. Many of you probably know exactly what I’m talking about – the first mcr-1 gene in E. coli has been found in a human in the US. The panic over this finding is that the mcr-1 gene carried by the E. coli bacteria makes it resistant to the antibiotic colistin, the drug used against particularly dangerous types of superbugs that can already withstand many other antibiotics. Even more concerning is the fact that the patient does not have any recent history of travel outside of the US – meaning they acquired it somewhere within the US!
If we look at the history of mcr-1, the first report came from China in late 2015, however investigations of historical isolates show that rare occurrences have been identified outside of the US since the 1980’s. Isolates have been found in humans, food, environmental samples and food animals in at least 20 countries worldwide showing that it’s a One Health problem when it comes to the war against antimicrobial resistance - people, animals and the planet are all connected.
In the US, prior to finding mcr-1 in a human, two samples had been found in pigs. Infection Prevention experts' biggest fear is that the gene will spread to bacteria that are now susceptible only to colistin. In all three cases in the US, the strain of E.coli has been different, but the gene was carried on a plasmid, a mobile piece of DNA that easily can transfer the gene to other bacteria. That would result in a kind of super-superbug, invincible to every life-saving antibiotic available.
If we can find the silver lining in the emergence of mcr-1, it’s the fact that from a cleaning and disinfection perspective, we know that antimicrobial resistance does NOT equal chemical resistance. Nor do we need to panic over whether or not the disinfectant we are using carries a claim against mcr-1. Over the years we have included several blogs on this topic including “Doors, Keys and Sledgehammers” and “I’ll take Kill Claims for $200”. I hope you’ll consider reading this to understand that while cleaning and disinfection is vitally important and that it needs to be completed correctly, consistently and without ‘cutting corners’, we do not need to panic over the tools we already have in our facilities. If your disinfectant has a claim against E. coli, you’ll be fine – heck if your disinfectant kills bacteria, you’ll be fine!