A week before the Sept. 27 death of Hugh M. Hefner from cardiac arrest and respiratory failure, the 91-year old Playboy founder was battling the blood infection septicemia and a drug-resistant strain of E. coli.

The new information about the publisher’s final days comes from his California death certificate, which, unlike many states, also lists contributing causes of a person’s demise.

Reports of how drug-resistant E. coli contributed to Hefner’s end is getting widespread attention in the nation’s entertainment media. Some visitors during the last six months of his life said Hefner was not well. His last public appearance was in 2016.

His celebrity is turning the spotlight on the World Health Organization’s (WHO) recent announcement that most antibiotic drugs now in development are only short-term solutions because they are only modifications of existing antibiotics. The WHO is worried because the list of superbugs that includes drug-resistant strains of E. coli, pneumonia and bacteria that cause urinary tract infections is getting longer.

The Escherichia coli bacteria or E. coli live in the intestinal tract. Only certain strains are harmful to humans. The pathogen is frequently spread via foodborne routes.

The drug-resistant strain that made Hefner was not specified, nor was the source.

Hefner’s other ailment – a blood infection – occurs when bacteria gets into the blood. It’s also known as Sepsis. It’s also treated with antibiotics and fluids. And while drug-resistant E. coli is rare, Sepsis kills more than 250,000 people a year in America.

Hefner founded Playboy magazine in 1953 and built a publishing and real estate empire around it under the theme of his style of sexual liberation. His death came at Playboy Mansion with his family including his third wife Crystal, age 31, present.

He was buried Sept. 30 at the Westwood Village Memorial Park in Los Angeles next to Marilyn Monroe, Playboy’s first centerfold. Hollywood is already working on a biopic.

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