Kasey Ferrell

Staff Writer

    “Nightmare bacteria” that have become increasingly resistant to the strongest antibiotics infected patients in 3.9 percent of all United States hospitals in the first half of 2012.  This includes 17.8 percent of specialty hospitals, public health officials stated on Tuesday, March 5, 2013.

    Dr. Tom Frieden, director of the Centers for Disease Control and Prevention said in a statement, “Our strongest antibiotics don’t work and patients are left with potentially untreatable infections,”  He said that doctors, hospitals, and public health officials must work together to “stop these infections from spreading.”

    At a news conference, he added, “It’s not often that our scientists come to me and say we have to sound the alarm, but that’s what we are doing today.”

    More and more hospitalized patients have been incurably infected with the bugs over the past decade.  Carbepenem-Resistant Enterobacteriaceae (CRE), according to a new CDC report, kill up to half of patients who get bloodstream infections from them.  The report did not say how many patients were killed by the bacteria, however.

    Enterobacteriaceae bacteria include more than 70 species the normally live in the water, soil and human digestive system - such as the more well-known E. coli.  Some of these types of bacteria have become resistant to all -or almost all- antibiotics over the years.  This, unfortunately includes last-resort drugs which are known as “carbapenems.”  The superbugs -present in one U.S. state in 2001- have now spread to 42, Frieden said at the news conference.

    The proportion of Enterobacteriaceae that are resistant to the last-ditch antibiotics rose from 1.2 percent to 4.2 percent over the past decade.

    Almost all CRE infections occur in patients who are receiving medical care for serious conditions in hospitals, long-term acute-care facilities (such as those providing wound care or ventilation) or nursing homes.

    These patients often have catheters or ventilator, which -as Frieden said, can allow bacteria to “get deeply into a patient’s body.”  In addition, such seriously ill patients ate often receiving antibiotics.  When the antibiotics “wipe out” susceptible bacteria, the coast is clear for CRE to proliferate.

    Eighteen patients at the National Institutes of Health Clinical Center in Bethesda, Maryland, contracted a CRE strain of Klebsiella pneumoniae in 2011, in one of the worst outbreaks.  Seven patients -including a 16-year-old boy- died.  The outbreak began when a patient unknowingly infected with CRE was transferred from a New York City hospital.

    The most cases of CRE are reported from northeastern states, which “is prevalent in a number of hospitals in the New York area,” said Dr. Arjun Srinivasan, CDC’s associate director for healthcare-associated infection prevention programs.  He said that patients and their families should ask a hospital or nursing home of it was monitoring for CRE and if it had any cases.

    Only six states require healthcare providers to report cases of CRE to public health authorities.

    Last month, CDC reported that unusual forms of CRE - with such unusual/exotic names as New Delhi Metallo-beta-lactamase and Verone Integron-mediated Metallo-beta-lactamase - are becoming more common in the United States.  Of the 37 unusual forms ever identified, the last 15 have been reported in July.

    The germs themselves spread from person to person -often on the hands of doctors, nurses and other healthcare professionals.  They can easily pass their antibiotic resistance -contained in a spec of genetic material- to other kinds of germs, making additional kinds of bacteria -potentially untreatable as well- CDC said.  -That can “create additional life-threatening infections for patients in hospitals and potentially for otherwise healthy people,” the CDC said in a statement.

    The CDC is trying to make healthcare facilities more aware of the resistant germs, since their spread can be controlled with proper precautions and better practices.  For instance, Israel cut CRE infection rates in all 27 of its hospitals by more than 70 percent in one year.

    Such measures include such standard infection control precautions as washing hands, as well as grouping patients with CRE together and dedicating staff, rooms, and equipment to the care of patients with CRE alone, as well as using antibiotics sparingly.  When an acute-care hospital in Florida had a yearlong CRE outbreak, implementing such measures cut the percentage of patients who got CRE from 44 percent all the way down to zero.