A group of potentially fatal germs that are difficult to treat because they resist antibiotics are becoming more of a threat, according to a U.S. report.
About 4 percent of U.S. hospitals and 18 percent of long- term acute care hospitals, such as those that provide ventilation and wound care, had an infection from carbapenem- resistant Enterobacteriaceae, in the first half of 2012, according to a report released today by the Atlanta-based Centers for Disease Control and Prevention.
This family of germs includes organisms such as Klebsiella and E. coli. Healthy people usually don’t get infected from these germs. Instead, people who are being treated for other illnesses, including those on breathing machines, or who have catheters inserted, are at risk, the agency said. These bugs are resistant to most antibiotics and contribute to the deaths of as many as half of the patients who become infected, the CDC said.
“CRE are nightmare bacteria,” Thomas Frieden, CDC director, said in a call with reporters. “They’re resistant to all or nearly all antibiotics, they have high mortality rates, and can spread their resistance to other bacteria. We only have a limited opportunity to prevent this from spreading to the community and more organisms.”
Though the resistant bugs are still fairly rare, the proportion of infections that were most dangerous increased to 4.2 percent in 2011, from 1.2 percent in 2001 in two of the surveillance systems used to track the bacteria. Most of that increase was in the Klebsiella species, which can cause pneumonia, bloodstream infections and meningitis.
The bacteria belong to a family that normally lives in the digestive system. They can cause infections in other places in the body, such as the bladder or blood, according to the CDC. Some of them are resistant even to the antibiotics of last resort, called carbapenems.
What’s worse, Frieden said, is that the CRE germs can easily swap genes with other bugs, creating new untreatable bacteria. While new antibiotics are under development for these germs, they are in early stages and “not likely to be available soon,” according to the CDC report.
To prevent the germs from spreading from hospitals into the community at large, the CDC recommends testing for CRE and keeping patients with the infection in specialized wards with dedicated staff. Handwashing among hospital staff is particularly important, Frieden said. Temporary medical devices such as catheters should be removed as soon as possible, and antibiotics should be prescribed wisely.
Unlike methicillin-resistant staphylococcus aureus or MRSA, CRE may not respond to any antibiotics. CRE infections aren’t as widespread as MRSA, which escaped the hospital setting.
CRE is “not as widespread, and it’s important we keep it that way, because it’s so dangerous in terms of high fatality rate, limited treatment options and ease of spreading,” Frieden said. “The sooner we act, the less likely it will be to get out into the community.”
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