A creepy, new hospital-acquired infection

There are many reasons why you should aim to stay healthy and out of the hospital. And here’s a big one: a dangerous new superbug called CRE.

This new superbug has hospitals scrambling. It’s nearly impossible to stop it from spreading. And it’s even harder to treat. In fact, half of all the patients infected with it die.

Even the longstanding problems with MRSA–another type of superbug–pale in comparison to the potential danger of the new superbug.

We call these bacteria “superbugs” because they rapidly evolved to become resistant to antibiotics.

For example, MRSA is just a common staphylococcus strain of bacteria. But it evolved and became resistant to the antibiotic methicillin, a penicillin-type drug.

Originally, most people acquired MRSA in hospitals or in nursing homes. But now, we see MRSA infections more and more in healthy folks, outside of healthcare settings. In places like gyms and school playgrounds.

MRSA has developed resistance to most antibiotics. Except to the strongest ones, known as “last-resort” drugs. But we can’t call them last-resort drugs anymore, thanks to this new superbug. This new bug is so strong, it doesn’t even respond to the last-resort antibiotics.

CRE is a strain of bacteria known as enterobacteriaceae. It became resistant to carbapenem-type antibiotics. The U.S. Centers for Disease Control and Prevention call the superbug “carbapenem-resistant enterobacteriaceae.” Or CRE for short.

CRE comes from the same family as E. coli. This family consists of more than 70 bacteria that live in your digestive system. Even in healthy individuals.

E. coli bacteria typically cause infections when they get into the bladder or blood. When they invade your blood, it’s deadly. But most of the time–until now– pathogenic strains of E. coli generally caused little trouble. Other than urinary infections. Or a bad case of “Montezuma’s revenge.”

But this minor strain of bacteria evolved. And now, it’s deadly. In fact, as I mentioned earlier, half of the patients infected with it die.

Almost all CRE infections currently occur in patients getting extensive medical care in hospitals or nursing homes. Reports show that nearly 200 U.S. hospitals and long-term care facilities treated at least one patient infected with CRE in the first half of 2012.

But here’s the problem…

The CDC says CRE has the ability to spread. It mainly spreads from unclean hands. So there’s real concern that yet another untreatable infection could spread to healthy people outside of hospitals.

Plus, CRE can transfer resistance to other bacteria within the same “family.” This would make all those strains of common bacteria untreatable as well. And remember, as I said earlier, everyone already has a profusion of E. coli in his or her GI tract. What happens if those strains of bacteria become resistant?

CRE infections are still not common. But they have increased from 1 percent to 4 percent of hospitals in the past decade, says the CDC. Plus, the rate of infection from one strain of CRE has increased from 2 percent to 10 percent.

According to the CDC report, 4 percent of hospitals treated a patient with a CRE infection in the first half of 2012. But about 18 percent of long-term acute care facilities treated a patient with a CRE infection during that time. And these facilities are generally less equipped to deal with exotic infections than are hospitals.

Without a doubt, this is a major reason to avoid hospital and rehab stays, if possible.

Nationwide 42 states reported at least one patient who tested positive for CRE during the last decade.

According to CDC Director Tom Frieden, M.D., M.P.H., “CRE are nightmare bacteria. Our strongest antibiotics don’t work and patients are left with potentially untreatable infections.”

The CDC recommends the following to help stop the spread of CRE:

1. If you get sick, tell your doctor if you’ve been hospitalized or in another facility or country recently.

2. Take antibiotics only as prescribed.

3. When hospitalized, insist that everyone wash his or her hands before touching you.

Hospitals can do a lot to stop the spread of CRE. In fact, other countries, like Israel, have seen dramatic decreases in CRE infections by following the CDC’s recommendations.

“[CRE] has not yet spread to the community–we have a window of opportunity to stop it before it becomes as prevalent as other organisms, such as MRSA,” said Dr. Frieden.

I’m concerned that Dr. Frieden may come off sounding a little like the boy who cried wolf. The CDC seems to cry wolf about non-existent threats sometimes. It likes to raise alarms to draw attention and receive funding. Especially during a time of long overdue government budget cuts. For example, remember last year’s Daily Dispatch about the CDC’s zombie-preparedness training?

Except this time, Dr. Frieden isn’t talking about zombies.

This time, something really scary is on the horizon. Will anyone listen?


  1. http://www.cdc.gov/hai/organisms/cre/cre-patients.html
  2. http://www.cdc.gov/features/vitalsigns/hai/cre/index.html
  3. http://www.cdc.gov/vitalsigns/HAI/CRE/index.html
  4. http://www.cdc.gov/media/releases/2013/t0305_lethal_cre.html