On Tuesday, the U.S. Centers for Disease Control and Prevention 's director, Tom Frieden, M.D., M.P.H. , sounded an alarm via telebriefing about an antibiotic-resistant strain of bacteria that pose a triple threat to health. The infections caused by these bacteria are acquired while patients are in the hospital or another type of medical care facility, referred to as nosocomial infections and most severely affect those people who are the most ill, have compromised immune systems and other risk factors.
Carbapenem-Resistant Enterobacteriaceae: 'Nightmare Bacteria'
Carbapenem-resistant enterobacteriaceae, or CRE, were labeled as "nightmare bacteria" by Frieden during his telebriefing due to the fact these germs can cause life-threatening infections in three separate ways:
* CRE are resistant to all, or nearly all antibiotics, even some of the last resort drugs
* CRE infections have high mortality rates, causing death to half the people who have serious
CRE infections
* CRE can spread their resistance to other bacteria by passing on the gene that results in
antibiotic-resistance.
Carbapenem-resistant enterobacteriaceae is a family of more than 70 different bacteria, including E. coli and klebsiella. These two commonly-known bacteria normally live in the intestines, but sometimes they get into places like the blood or bladder, causing infections there.
When bacteria in the enterobacteriaceae become resistant to the use of antibiotics, they are then termed "CRE."
Who is Most Vulnerable to Acquire CRE Infections?
The risk of infection is highest in people receiving complex medical care or in long-term medical care; these are patients most vulnerable to acquire any infection due to invasive tubes and devices such as catheters, ventilator tubes and more. The most likely settings for CRE infections are hospitals or long-term care facilities.
CRE is spread person-to-person, most often from unwashed hands.
How Prevalent are CRE Infections?
The CDC reported that in 2001, CRE was tracked in one health care facility in one state; now there have been reports of the infection in 42 states. In the first half of 2012, at least one CRE infection was treated in nearly 200 health care facilities.
At this time, all known CRE infections have occurred only within health care facilities. The CDC is implementing programs to prevent the spread of the life-threatening infections from reaching into communities.
The good news is that health care facilities and even other countries who have implemented the CDC's "Detect and Protect" program to reduce CRE infections have shown reduced incidence of the drug-resistant infectious agents.
What's Being Done to Protect Public Health?
The CDC is encouraging all health departments and leaders in health facilities and organizations to follow the "Detect and Protect" program the federal public health agency developed and have met with success.
In addition to clinicians needing to determine if a patient has a CRE infection with an immediate alert from the lab if such is noted, there is a four-pronged approach to the prevention, spread, and treatment of potential CRE infections, including limiting the use of antibiotics only when medically necessary.
Bottom Line
Hand washing by hospital personnel is as important as ever to prevent the spread of CRE from person-to-person. Don't hesitate to ask a health care provider to wash his/her hands before providing care to you or a loved one. Don't insist on being prescribed antibiotics when your physician says they aren't needed or won't be useful, as in when you have a viral illness.
And you might want to contact your elected officials about the continued use of antibiotics in animals for food.
