Six new patients in Colorado were diagnosed with infection of a superbug known as carbapenem-resistant Enterobacteriaceae (CRE). Even scarier, the patients appeared to have contracted the microbe outside of the hospitals, which is highly unusual.
The name CRE encompasses a family of bacteria that are extremely resistant to nearly all antibiotics. These include Klebsiella species and E. coli, which can acquire resistance to carbapenem – a class of antibiotic deemed as the “last resort.” Given these properties, it’s no wonder why CRE bacteria are considered ‘nightmare’ superbugs.
While nearly all CRE infections have been documented in sick people who have spent time in the hospitals, nursing homes, and other healthcare environments, the 6 new cases had different origins. In particular, none of the patients had any contact within a clinical setting for at least a year prior to being diagnosed. One patient was pregnant, 2 patients had underlying medical conditions, and 3 patients were otherwise healthy.
The findings suggest the CRE superbug is becoming “community-associated.” That is, the bugs are spreading to areas outside of their typical clinical facility niches. This is scary news, considering that CRE infections can be extremely deadly. As many as 50 percent of infected patients succumb to the infection as antibiotic options run out.
"These bacteria might be moving from health care to community settings," said Sarah, an infections epidemiologist at the Colorado Department of Public Health and Environment. "Further surveillance of CRE is needed to determine whether this pattern continues in Colorado and to determine if this trend is occurring in other parts of the United States," Janelle said.
Of note, the type of CRE superbugs found in all 6 patients is considered rare in the United States. As such, doctors considered receiving medical treatments while abroad to be a risk factor for CRE infection.
In addition, the doctors also highlighted that unnecessary antibiotic use can enable infections with superbugs. "Any time antibiotics are used, this puts biological pressure on bacteria that promotes the development of resistance," Janelle said.
"Proper use of antibiotics can slow the development of resistance in bacteria and can preserve this life-saving resource," said Janelle.
The World Health Organization (WHO) recommends several precautions to stop antibiotic resistance. WHO specifies that antibiotics should not be prescribed unless the infection is bacterial in nature and should respond to antibiotics. Unfortunately, nearly 50 percent of antibiotics prescribed for respiratory infections may be unnecessary, as physicians can mistake viral infections for bacterial infections. As such, the bottom line seems counterintuitive: to stop the rise of antibiotic-resistant bacteria, we should limit the use of antibiotics.