A vitally serious situation has developed in hospitals and nursing homes across the country: certain bacteria known as “nightmare bacteria” are taking root and proving immune to antibiotics. These bacteria, known as Carbapenen-Resistant Enterobacteriaceae, or CRE, are a monumental threat because of three attributes: they do not respond to “last resort” antibiotics, called carbapenems; they kill virtually half of the patients who harbor them; and they can give their own resistance to antibiotics to other bacteria, such as E. coli, which widens the number of bacteria immune to treatment. E. coli is quite common; it is the leading cause of urinary tract infections.
Thomas Frieden, director of the Centers for Disease Control and Prevention, was truly concerned, saying, “It’s not often that our scientists come to me and say we have a very serious problem and we need to sound an alarm. But that’s exactly what we are doing today.” Another expert said that if these bacteria are not stopped, antibiotics may soon be helpless to fight bacterial infections. He said, “Our strongest antibiotics don’t work, and patients are left with potentially untreatable infections.”
One of the “nightmare bacteria,” carbapenem-resistant Klebsiella, wrought havoc at the National Institutes of Health facility two years ago. Nineteen people got sick; 12 of them died. Seven of the deaths were ascribed to an antibiotic-resistant strain of the bacterium Klebsiella pneumoniae, and all seven either had cancer-weakened immune systems, had taken anti-rejection drugs given after organ transplants, or suffered from genetic disorders. It didn’t matter that the staff took drastic measures to address the problem, such as quarantining infected patients and replacing plumbing. Equipment, walls, railings and patients were scrubbed assiduously, but the infection lasted more than a year on the premises.
Most CRE infections strike patients who are in serious condition, whether in hospitals, nursing homes, or long-term acute-care facilities. It is common among patients who need catheters or ventilators, since those present avenues for the bacteria to burrow deep into the body. The bacteria can be spread through contact, thus keeping people and equipment sterile is vital.
In the period from 2001 to 2011, Enterobacteriaceae resistant to antiobiotics almost quadrupled, from 1.2% to 4.2% of bacteria in general. The strain involved in the NIH incident has multiplied by seven.
Tennessee, Minnesota, Colorado, Wisconsin, Oregon and North Dakota are the only states that require hospitals and health-care facilities to report CRE infections to state health departments.
CDC officials warned patients to make sure their doctors and nurses wash their hands before touching them, the officials said. They also asserted that demand for antibiotics be reduced, fearing that the more antibiotics are used, the more antibiotic resistance will grow.