Clinical management of resistance evolution in a bacterial infection: A case study

Robert J Woods; Andrew F Read

doi:10.1093/emph/eov025

Clinical management of resistance evolution in a bacterial infection: A case study

Evol Med Public Health. 2015 Oct 10;2015(1):281-8. doi: 10.1093/emph/eov025.

Authors

Robert J Woods¹, Andrew F Read²

Affiliations

¹ Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA robertwo@med.umich.edu.
² Department of Biology, Center for Infectious Disease Dynamics, Pennsylvania State University, University Park PA 16802, USA Department of Entomology, Center for Infectious Disease Dynamics, Pennsylvania State University, University Park PA 16802, USA.

Abstract

We report the case of a patient with a chronic bacterial infection that could not be cured. Drug treatment became progressively less effective due to antibiotic resistance, and the patient died, in effect from overwhelming evolution. Even though the evolution of drug resistance was recognized as a major threat, and the fundamentals of drug resistance evolution are well understood, it was impossible to make evidence-based decisions about the evolutionary risks associated with the various treatment options. We present this case to illustrate the urgent need for translational research in the evolutionary medicine of antibiotic resistance.

Keywords: Enterobacter; MRSA; antibiotic resistance; clinical decisions; evolutionary risk; resistance management.

Publication types

Case Reports