Friday, 7 December 2012

A SuperBug Named CRE



Ever heard of ‘CRE’? Well by the sound of it, you may be hearing more about it in your future. What is it? Just an extremely deadly strain of bacteria that is entirely immune to all antibiotics on earth… The bacteria, known as Carbapenem-Resistant Enterobacteriaceae, or CRE, are named for their ability to fight off carbapenem antibiotics — the last line of defense in the medical community’s toolbox. And so far, they’ve emerged almost exclusively in health care facilities, picking off the weakest of patients.

The bacteria’s ability to defeat even the most potent antibiotics has conjured fears of illnesses that can’t be stopped. Death rates among patients with CRE infections can be about 40 percent, far worse than other, better-known health care infections such as MRSA or C-Diff, which have plagued hospitals and nursing homes for decades. And there are growing concerns that CRE could make its way beyond health facilities and into the general community.

Research shows there have been thousands of CRE cases throughout the country in recent years. “From the perspective of drug-resistant organisms, (CRE) is the most serious threat, the most serious challenge we face to patient safety,” said Arjun Srinivasan of the Centers for Disease Control and Prevention.

CRE infections already are endemic in several major U.S. population centers, including New York, Los Angeles and Chicago. Smaller pockets of cases have been reported across much of the country, including Oregon, Wisconsin, Minnesota, Pennsylvania, Maryland, Virginia and South Carolina.

There is little chance that an effective drug to kill CRE bacteria will be produced in the coming years. Manufacturers have no new antibiotics in development that show promise.

USA TODAY’s research shows there have been thousands of CRE cases throughout the country in recent years — they show up as everything from pneumonia to intestinal and urinary tract infections. “these (bacteria) are going to greatly impact the kind of surgeries (and) treatments we can have,” says a infectious-disease doctor at the University of Iowa’s Carver College of Medicine. “We’re entering the post-antibiotic era; that’s a very big problem.”

The bacteria cycle from one facility to the next — and back. “It is continually reintroduced; I don’t think it is going away,” says David Landman, an infectious-disease doctor at the State University of New York’s Downstate Medical Center in Brooklyn. “You need extreme control efforts.”

The big fear is that the genes may start to convey resistance to more common strains of the bacteria, turning routine illnesses, such as urinary tract infections, into untreatable nightmares. Worst-case scenario: Resistance could move to bacteria outside of health care, so people could pick it up in the community through something as simple as a handshake.

Since we began living in the age of antibiotics, our life expectancy and population growth have exploded. The thing is, nature has a way of overcoming such obstacles, and in many ways it looks like she is making inroads. After such a long while, we begin to believe that we are indestructible and can overcome anything. While this sense of indestructibility may be part of an attitude that contributes to some success via risk taking, it can also be a weakness in that we sometimes do not effectively see the risks that are around us. The invisible ones can be the hardest to see…

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