August 12, 2014
A new deadly superbug that is almost totally resistant to antibiotics and kills about half who get bloodstream infections has found its way to community hospitals in the Southeastern United States, Laura Ungar reports for The Courier-Journal.
“We haven’t seen much here, but I’m sure it’s coming,” Forest Arnold, an epidemiologist at University of Louisville Hospital and an associate professor of infectious diseases at the university, told Ungar.
CRE, short for carbapenem-resistant Enterobacteriaceae, are a family of bacteria that have, over time, become resistant to antibiotics called carbapenems, which are considered drugs of last resort for this type of infection. It can cause a range of illnesses depending on where it infects the body, ranging from gastrointestinal illness to pneumonia to bloodstream infections.
A recent study in the journal Infection Control and Hospital Epidemiology indicates CRE increased “fivefold” at community hospitals in several southeastern states from 2008 to 2012, Ungar reports. Kentucky was not part of the study, but researchers say the rates “reflect a growing problem across the region and throughout the country.”
“People need to be aware,” Arnold told Ungar. “It will eventually get here.”
Experts report that overuse of antibiotics is one of the main reasons for these superbugs, Ungar writes. And Dr. Kevin Kavanaugh, an infection-control activist who leads the Somerset-based watchdog group Health Watch USA, told Ungar that Kentucky has one of the nation’s highest rates of antibiotic use, sometimes prescribed unnecessarily.
“CRE is very dangerous,” Kavanagh said. “It is almost totally resistant to antibiotics.”
Ungar reports that local hospitals have seen growing numbers of CRE, citing examples of University Hospital with a case last year in which the patient died, and Norton Healthcare, with three cases in the first three months of last year and 10 others between 2010 and 2013.
Last year, the federal Centers for Disease Control and Prevention warned that CRE had spread from one medical facility in 2001 to numerous facilities in 46 states in 2013, Ungar notes. CDC Director Tom Frieden has labeled CRE “nightmare bacteria,” calling them the worst of the growing list of antibiotic resistant germs that “take hold in health care settings.”
One in 25 hospitalized patients has at least one health care-associated infection on any given day, according to the U.S. Centers for Disease Control and Prevention, with C. difficile, which causes 14,000 American deaths per year and MRSA, which one study shows kills 18,000 Americans a year, being two of the most common, Ungar reports.
Doctors say they hope to control CRE before it becomes as common as MRSA, which has spread to communities, Ungar reports.
“So far, CRE are just in the health care setting,” Kavanagh told Ungar. ” ‘If it continues to grow and escape into the community, it will be an even bigger problem’ and the medicines doctors count on to cure bacterial infections will no longer work against them.”
Kavanaugh told Ungar that “antibiotics should be used only when they are absolutely necessary, and hospitals must remain vigilant about ensuring health care workers wash their hands often, keep rooms and medical equipment clean, wear gowns and gloves when appropriate and separate infected patients from others.”
“If the emergence and spread of superbugs aren’t prevented,’we’ll be in a post-antibiotic era’,” Kavanagh told Ungar. “And the danger is not going to go away unless we change the course of how we do things.”