CDC microbiologist Johannetsy Avillan holds up a plate that demonstrates the modified Hodge test, which is used to identify resistance in bacteria known as Enterobacteriaceae. CRE Bacteria that are resistant to carbapenems, considered "last resort" antibiotics, produce a distinctive clover-leaf shape. / CDC
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Deadly drug-resistant bacterial infections are on the rise in U.S. hospitals, and federal health officials are asking health care facilities around the country to take urgent action.
These so-called "superbugs" called carbapenem-resistant Enterobacteriaceae (CRE) are dangerous, according to the CDC. They kill one in two patients who develop bloodstream infections from them. Even the most powerful last-resort antibiotics can't treat them.
"CRE are nightmare bacteria. Our strongest antibiotics don't work and patients are left with potentially untreatable infections," Dr. Tom Frieden, director of the Centers for Disease Control and Prevention (CDC) said in a statement. "Doctors, nurses, hospital leaders, and public health, must work together now to implement CDC's "detect and protect" strategy and stop these infections from spreading."
The CDC's new Vital Signs report, published March 5 on CDC.gov, details a decade-long rise in rates in inpatient medical care facilities like hospitals, nursing homes and long-term acute care centers that treat patients recovering from serious injuries and illnesses.
CRE infections are caused by a family of germs called Enterobacteriaceae that consist of 70 bacteria, including Klebsiella pneumonia (the bacteria that causes pneumonia and other infections) and E. coli that normally live in your digestive system. Some of the germs have become resistant to the strongest type of antibiotics called carbapenems. Almost all CRE infections happen to patients receiving serious medical care, the CDC said.
CRE were relatively uncommon in the U.S. in 2000, according to the report, which tracked infection rates at more than 3,900 U.S. hospitals from 2001 to 2012. The percentage of reported cases rose from 1 percent of patients in 2001 to 4.2 percent of patients ten years later, with the largest spike in Klebsiella infections.
Forty-two states reported having had at least one patient test positive for one type of CRE with most infections reported in the Northeast. About 18 percent of long-term acute care hospitals and about 4 percent of short-stay hospitals in the U.S. reported at least one CRE infection during the first half of 2012 alone.
While overall rates remain low, the CDC warns that CRE can spread their antibiotic resistance to other germs as well, and routine bladder or wound infections at hospitals could be deadly.
That's why the agency is calling on hospitals to follow an aggressive "Detect and Protect" action plan. Recommendations include enforcing infection control precautions, grouping patients with CRE together and dedicating staff, rooms and equipment to CRE to prevent transmission. Patients should tell doctors if they've been hospitalized in another facility, take their antibiotics exactly as prescribed and insist health care personnel wash their hands before touching them.
CRE can be carried by patients from one health care facility to another so the CDC encourages hospitals to work together regionally to implement CRE prevention programs.
Israel decreased CRE infection rates in all 27 of its hospitals by more than 70 percent in one year with a prevention program, the CDC reported as an example.
"We have seen in outbreak after outbreak that when facilities and regions follow CDC's prevention guidelines, CRE can be controlled and even stopped," said Dr. Michael Bell, acting director of CDC's Division of Healthcare Quality Promotion. "As trusted health care providers, it is our responsibility to prevent further spread of these deadly bacteria."
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