"Nightmare bacteria" that have become increasingly
resistant to even the strongest antibiotics infected patients in 3.9% of all US
hospitals in the first half of 2012, including 17.8% of specialty hospitals,
public health officials said on Tuesday.
"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, said in a statement.
He said doctors,
hospitals and public health officials must work together to "stop these infections
from spreading."At a news conference, he added, "it's not often that
our scientists come to me and say we have to sound the alarm, but that's what
we are doing today."
patients affected with bugs
Over the past decade more and more hospitalised patients
have been incurably infected with the bugs, Carbapenem-Resistant
Enterobacteriaceae (CRE), which kill up to half of patients who get bloodstream
infections from them, according to a new CDC report.
The report did not say how many patients were killed by the
bacteria. Enterobacteriaceae bacteria include more than 70 species that
normally live in the water, soil and human digestive system, such as the
well-known E. coli.
Over the years, some Enterobacteriaceae have become
resistant to all or almost all antibiotics, including last-resort drugs known as
carbapenems. Present in one US state in 2001, the superbugs have now spread to
42, Frieden said at the news conference.
Over the past decade, the proportion of Enterobacteriaceae
that are resistant to the last-ditch antibiotics rose to 4.2% from 1.2%. Almost
all CRE infections occur in patients receiving medical care for serious
conditions in hospitals, long-term acute-care facilities (such as those
providing wound care or ventilation) or nursing homes.
These patients often have catheters or ventilators, which
can allow bacteria "to get deeply into a patient's body," Frieden
said. In addition, such seriously ill patients are often receiving antibiotics.
When the antibiotics wipe out susceptible bacteria, the coast is clear for CRE
In one of the worst outbreaks, 18 patients at the National
Institutes of Health Clinical Center in Bethesda, Maryland, contracted a CRE
strain of Klebsiella pneumoniae in 2011. Seven patients, including a 16-year-old
boy, died. The outbreak began when a patient unknowingly infected with CRE was
transferred from a New York City hospital.
Northeastern states report the most cases of CRE, which
"is prevalent in a number of hospitals in the New York area," said Dr
Arjun Srinivasan, CDC's associate director for healthcare-associated infection
prevention programs. He said patients and their families should ask a hospital
or nursing home if it was monitoring for CRE and if it had any cases.
Patients who required
Only six states require healthcare providers to report cases
of CRE to public health authorities. Last month, CDC reported that unusual
forms of CRE - with such exotic names as New Delhi Metallo-beta-lactamase and
Verona Integron-mediated Metallo-beta-lactamase - are becoming more common in
the United States. Of the 37 unusual forms ever identified, the last 15 have
been reported since July.
The germs themselves spread from person to person, often on
the hands of doctors, nurses and other healthcare professionals. They can
easily pass their antibiotic resistance - contained in a speck of genetic
material - to other kinds of germs, making additional kinds of bacteria
potentially untreatable as well, CDC said.
That "can create additional life-threatening infections
for patients in hospitals and potentially for otherwise healthy people,"
the CDC said in a statement. The CDC is trying to make healthcare facilities
more aware of the resistant germs, since their spread can be controlled with
proper precautions and better practices.
Israel, for instance, cut CRE infection rates in all 27 of
its hospitals by more than 70% in one year. Measures include such standard
infection control precautions as washing hands, as well as grouping patients
with CRE together and dedicating staff, rooms and equipment to the care of
patients with CRE alone, and using antibiotics sparingly.
When an acute-care hospital in Florida had a yearlong CRE
outbreak, implementing such measures cut the percentage of patients who got CRE
to zero from 44%.