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An elderly woman in Washoe County, Nevada succumbed to a bacterial infection resistant to all 26 antibiotics available in the United States last year. The infection, caused by carbapenem-resistant Enterobacteriaceae (CRE), is potentially fatal since it's a multidrug-resistant organism.

The woman, in her 70s, had traveled to India and developed septic shock after being infected with the potent and aggressive bacteria. The cause of her death was publicly reported in an article by the Centers for Disease Control and Prevention (CDC) titled "Morbidity and Mortality Weekly Report".

Though CRE infections are not new to Nevada or the country, this particular case is new since it was resistant or non-susceptible to all available antimicrobial drugs.

"We have a shrinking world," Randall Todd of the Washoe County, Nevada health department, said as reported by NBC News.

Aggressive, Potent Infection

The patient was admitted to an acute care hospital in August 2016 after a trio in India. A primary diagnosis of systemic inflammatory response syndrome was given, probably resulting from an infected right hip seroma. However, the doctors said the infection was serious and none of the 14 antibiotics they prescribed worked, the University of Minnesota reports.

Laboratory testing confirmed that Klebsiella pneumoniae, one of the more common types of CRE. A wound specimen was sent to the CDC for further testing and to determine the mechanism of resistance.

CDC tests confirmed the presence of New Delhi Metallo-beta-lactamase (NDM-1), an enzyme that directly breaks down carbapenems, a potent class of antibiotics that are used to treat multi-drug resistant infections.

The NDM-1 mutation makes it more drug-resistant. Despite the fact that most CREs in the country can be killed by the last resort antibiotics, those carrying the mutation resist even more types of drugs.

Further tests show that the bacteria is, in fact, resistant to all 26 different antibiotics including polymixins and aminoglycosides, which are considered "last line" antimicrobials. The aggressive pathogen was also resistant to tigecycline, an antibiotic developed to treat drug-resistant organisms.

Thus, there were no other options in treating the elderly woman. She died of septic shock in early September 2016.