What Is CRE? Should You Be Alarmed?
CRE stands for carbapenem-resistant Enterobacteriaceae, and it is spreading in U.S. health facilities at an alarming rate. According to the CDC, there are reports of unusual forms of CRE and they have nearly doubled in the U.S. The name CRE came from its ability to evade the super-strong carbapenem antibiotics which are called the last line of defense in prescribed antibiotics.
The mortality rate for this superbug could be up to 40%. A number that is shockingly higher than those of the infections caused by MRSA and other recent superbugs. This strain is so treatment resistant that warnings have been given to hospitals, nursing homes, and all healthcare facilities.
According to CDC director Tom Frieden, “our strongest antibiotics do not work on CRE, and people are left with untreatable infections.” Additionally, it can take over a year before a carrier of this superbug will test negative for it. Therefore, this strain will be harder to control and will increase the risk of a wider geographic spread of the disease.
Furthermore, according to officials, up to half of all patients who get bloodstream infections from this bacterium will die. Now comes the question of antibiotic overuse and how to make an antibiotic-dependent nation change its habits.
So what are the state and local officials doing to stop the threat of these drug-resistant organisms? USA Today interviewed dozens of healthcare officials. They also studied hundreds of journals, and clinical reports, and scoured multitudes of state and federal healthcare data.
What they discovered is that CRE is already in epidemic status in several major US cities. However, there is no reliable national data as to the scope of the problem. The CDC has urged state officials to track their cases but only a few do.
Manufacturers are reporting that no new antibiotics are currently in development that shows any sign of being effective for CRE infections. And, according to industry experts, there is little to no financial incentive to fund this type of project because this superbug adapts so quickly to resist each newly designed drug.
One of the major hurdles in how to contain the spread of CRE is figuring out where it is showing up since there is no federal reporting requirement. Therefore, if officials don’t know exactly how big the problem is or even where the problem is, how are they going to carry out a strategy to contain it?
Industry experts have alluded that the only way to combat CRE is through traditional infection control strategies such as:
- Rigorous hand washing.
- Isolating infected patients.
- Requiring gowns and gloves for any person in contact with an infected patient.
- Cutting antibiotic use to reduce the development of these superbugs.
- Limiting the use of invasive medical devices like catheters, etc.
- Screening all patients for this bacterium to isolate carriers.
Fortunately, there is some good news going forward. Doctors have learned that the gene is attaching itself to other bacteria on mobile pieces of DNA that move from one cell to another. Additionally, researchers have now learned what is causing some of those problems and can now concentrate on attacking them at their source.
However, it doesn’t look like this bacterium is going away anytime soon. It’s always there and will always be a threat. The best course of action to take, according to industry experts, is to follow traditional infection control strategies, continue tracking and monitoring this disease, and keep awareness at the forefront of all potential cases of CRE. Maybe then this superbug has the possibility of being somewhat contained. Only time will tell!