Resistant bacteria on the rise

There is a bacteria that has become resistant to even the strongest antibiotics, and it can contribute to the deaths of up to half the people infected when it gets into the bloodstream, according to the Centers for Disease Control and Prevention. Carbapenem-resistant enterobacteriaceae is "a family of germs that are difficult to treat because they have a high level of resistance," according to the CDC.

CRE can be transmitted through the hands of healthcare personnel, and the bacteria can spread its antibiotic resistance to other bacteria in the same family, the CDC says.

"CRE can be transmitted via healthcare workers or the hospital environment," Dr. Daniel Uslan, an epidemiologist and director of the Antimicrobial Stewardship Program at the University of California, Los Angeles Health System, states in an email.

According to the CDC, medical care that requires devices like ventilators, urine catheters, or intravenous catheters, and patients who are taking long courses of certain antibiotics are most at risk.

"It can get into the bloodstream from another site of infection like a urinary tract infection, or long-term use of central venous catheter or a PICC line commonly used for dialysis or chemotherapy," says Uslan.

Infections are usually associated with symptoms that vary based on the site that is infected — a cough if in the lungs and urinary symptoms if in the bladder. General symptoms of an infection are flulike and can include a fever, chills and cough, the CDC says.

The family of CRE has more than 70 bacteria, including E. coli and Klebsiella pneumoniae that normally live in the digestive system.

"These enterobacteria, or gut bacteria, live with us, and some of these bacteria like E. coli help us out by providing vitamin K, while other bacteria of this same species can cause disease," Lucy Kluckhohn-Jones, a Santa Monica College life science professor, states in an email. During the last decade, the CDC says that it has tracked one type of CRE from a single healthcare facility to facilities in at least 42 states.

A CDC vital signs report states that in the first six months of 2012, 4.6 percent of acute-care hospitals treated one or more patients with CRE infections and 17.8 percent of long-term, acute-care facilities treated at least one patient with a CRE infection.

The CDC also says that today, there are germs that are stronger than any antibiotics known to treat them.

Widespread overuse of antibiotics is fueling antibiotic resistance and is causing even more problems faced by patients, says the CDC.

"Patients frequently request antibiotics for infections that are viral such as the common cold, bronchitis, ear infections," says Uslan. "Physicians over-prescribe antibiotics in response to many factors, including diagnostic uncertainty, patient pressure, or a concern of missing a bacterial infection."

"Taking too many antibiotics doesn't cause disease," says Kluckhohn-Jones. "What it does instead is to wipe out the bodies diverse bacterial populations, leaving the resistant bacteria to cause disease."

Uslan believes the infection will not spread to those in the general population, but is more prone to strike those who are critically ill or those needing long-term care. Once a person becomes infected, there is not much that can be done.

"This means if a person has CRE infection, we have very limited options to treat it," he says. "In some ways, we've returned to the pre-antibiotic era with this organism."

The CDC has a toolkit that contains ways to prevent CRE for both patients and those providing the care.

For patients, make sure doctors, nurses and other healthcare providers wash their hands before touching the body or something going into the body.

For clinicians, know if someone is hospitalized with CRE at your facility. Remain aware of the rate of infection, and find out if a patient has been hospitalized in another hospital or another country.

The CDC also says that there is a coordinated regional control effort among healthcare facilities, recommended to prevent the spreading of CRE.

Tina EadyComment