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Part I – The Rise of the Super Bug
I was sitting in a hospital bay and I wasn’t really worried. I get urinary tract infections all the time. It happens when you have Berger’s disease, a type of auto-immune thing that affects the kidney, so that you have to get dialysis to do what the kidneys are supposed to do. So getting urinary track infections is no big deal. I had been to the doctor a couple of times already, but the pills he gave me didn’t seem to be working. I was already here for my dialysis treatment, so I figured maybe the hospital doctors could give me something more powerful to help clear up the infection faster. I expected to get some IV antibiotics, sit around bored, and then be on my way. I was just visiting my cousins in India. Maybe I should have taken their offer and gotten some powerful antibiotics. It still amazes me that you don’t need a prescription to get them over there; it would’ve made my life easier if they were so easy to get at home.

A nurse comes in briskly. “We’re going to move you to your own room, honey.”

I should be excited. You know, my own TV without all the noise and craziness just being in a curtained bay. But the nurse looks worried and she is pushing my bed along kind of fast. There is a ton of activity in the hospital bay I left as I see the other patients in the neighboring bays are being moved as well. What weirdness is this about? I’m getting a little worried.

“The doctor will be with you shortly,” she says. But I don’t believe that. Doctors take forever. That’s why I am surprised when he comes along 10 minutes later.

“Ok, ahh… Sam,” he says, consulting my chart. “We got your test results back and it looks like your bacterial infection is very serious.”
Ok, now I am really worried and maybe even a little bit scared because I just don’t understand why this time is different and worse than the others. •

Yeah, so I guess I was the first U.S. patient with the New Delhi Super Bug. Instead of my normal stay in the hospital, I was there for weeks. I barely got to see anyone since I was quarantined. According to the doctors, I probably picked up the bacteria when I was getting dialysis at the hospital on my vacation in India. I really don’t understand why my infection was a super bug. What exactly is a “super bug”? What makes infection with a super bug different from my other infections?

While I sat there in the hospital room, I couldn’t watch any more daytime television, so I decided to do a couple of internet searches. I mean really; I’m not a pre-med student for nothing. So, Wikipedia first…it seems that a super bug is just a hyped up way of saying that the drugs used to treat the infection don’t. These “super bugs” apparently have antibiotic resistance. Here’s one of the “visuals” I found:

CENTER FOR CASE STUDY TEACHING IN SCIENCE

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So while I thought this information on antibiotic resistance was helpful, what exactly does this have to do with me sitting here forever? I Googled “Super Bug” and found a variety of news stories. Here's an “extract” from one of them:

“Doctors in India aren’t surprised that the Super Bug probably originated there. Drug control there is poor and common antibiotics have become ineffective in India. Some reasons may be because people can buy powerful antibiotics over the counter, leading to overuse. They also take small doses and discontinue treatment in order to save money. There are no current antibiotics, nor any in development, that can kill New Delhi Super Bug on their own.” –Vinny Ciancio (AccessRx)

Questions
1.What do you think could allow some of the bacteria to live even in the presence of antibiotics? (Hint: Are all the bacteria in a population the same? How might they differ?)

I think the mutation and using a built-in design feature to swap DNA, called horizontal gene transfer—bacteria share resistance genes. If the bacteria have a mutation in the DNA which codes for