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Deadly Superbug CRE Linked To 2 Deaths In Los Angeles – What You Need To Know

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Robert J. Szczerba Contributor

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Carbapenem-resistant Enterobacteriaceae (CRE) is a deadly strain of antibiotic-resistant bacteria that was recently linked to two deaths at the Ronald Reagan UCLA Medical Center in Los Angeles.  Seven patients initially contracted CRE after routine endoscopic treatments.  The hospital is contacting 179 others who had endoscopic procedures over the past four months.

Scientists often refer to CRE as “nightmare bacteria”, because the strains are difficult to treat due to being extremely resistant to antibiotics.  Additionally, CRE can lead to death in up to 50% of patients who become infected.  Below is a quick summary from the Centers for Disease Control and Prevention (CDC) about what you need to know about CRE infections:

What is CRE?  Enterobacteriaceae are a family of bacteria found in normal human intestines (gut).  Sometimes these bacteria can spread outside the gut and cause serious infections, such as pneumonia, bloodstream infections, urinary tract infections, and meningitis.  Enterobacteriaceae are one of the most common causes of bacterial infections in both healthcare and community settings.  However, some experts say that overuse and misuse of antibiotics causes some bacteria to become resistant to traditional forms of treatment.

Carbapenem are a class of antibiotics frequently used to treat severe infections.  Carbapenem-resistant Enterobacteriaceae (CRE) are a class of Enterobacteriaceae that are difficult to treat because they are resistant to commonly used antibiotics.

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Who is at risk for CRE?  It’s important to note that healthy people usually don’t get CRE infections.  Such infections are most commonly seen in people with exposure to healthcare settings such as hospitals and long-term care facilities.  In healthcare environments, CRE infections generally occur among sick patients who are receiving treatment for other conditions.  Patients whose care requires devices like ventilators (breathing machines), urinary (bladder) catheters, or intravenous (vein) catheters, and patients who are taking long courses of certain antibiotics are among those at highest risk for CRE infections.

How does one contract a CRE infection?  Simply put, to contract a CRE infection, a person must be exposed to CRE bacteria.  This bacteria is most often spread person-to-person in healthcare settings through contact with infected individuals, particularly contact through wounds or stool.  CRE can cause infections when they enter the body, often through medical devices like intravenous catheters, urinary catheters, or through wounds caused by injury or surgery.

What are the symptoms and treatments for CRE infections?  When found in clinical environments, CRE can represent an infection or colonization.  Colonization means that the organism can be found on the body but is not causing any symptoms or disease.  Colonizing CRE strains can go on to cause infections if they gain access to body sites that are usually sterile like the bladder, lungs, or bloodstream.  Infections are usually associated with symptoms, which vary based on the infected site (e.g., cough if in the lungs, urinary symptoms if in the bladder) but can also include general symptoms like fever or chills.

CRE are often resistant to many commonly prescribed antibiotics but may still remain susceptible to one or more antibiotics.  A healthcare provider should make decisions on treatment of CRE infections on a case-by-case basis.  Some people might be colonized rather than infected with CRE and may not require any treatment at all.

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