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Deadly, mostly untreatable bacteria on rise at nation's nursing homes, hospitals, CDC warns

About Luis Fábregas
Picture Luis Fábregas 412-320-7998
Medical Editor
Pittsburgh Tribune-Review

Luis Fábregas is an award-winning reporter who specializes in medical and healthcare issues as a member of the Tribune-Review’s investigations team.

By Luis Fábregas

Published: Tuesday, March 5, 2013, 5:09 p.m.

Infections caused by a deadly, largely untreatable bacteria are on the rise among hospitalized patients across the country, the Centers for Disease Control and Prevention warned on Tuesday, but the agency declined to provide specifics beyond the region where cases were reported.

The CDC instead called on health care facilities to conduct intense monitoring for the bacteria, known as CRE or carbapenem-resistant enterobacteriaceae. CRE germs are resistant to nearly all available antibiotics and kill up to half of the patients who get bloodstream infections from them, said Dr. Tom Frieden, the CDC's director.

“CRE are nightmare bacteria,” Frieden said. “Our strongest antibiotics don't work, and patients are left with potentially untreatable infections.”

During the first six months of 2012, 181 of the nation's 3,918 acute-care hospitals, or 4.6 percent, reported one or more infections with CRE, the CDC said. The infections tend to occur in people who receive extensive medical care, often in long-term acute-care facilities such as nursing homes.

Despite making public its concerns, the CDC declined to even identify specific states where CRE cases have been reported. The agency would say only that the bacteria have been reported by health care facilities in 42 states. The largest number of facilities reporting CRE infections, 63, were in the Northeast region, which includes Pennsylvania and eight other states, the agency said.

Also reporting CRE cases were 50 facilities in the South, 30 in the Midwest, 29 in the West and nine in other locations, including Puerto Rico, the Virgin Islands and among the armed forces. The CDC relies on hospitals to report CRE and other infectious cases to state health departments, which, in turn, report the cases to the federal agency.

Only six states require CRE reporting: Colorado, Minnesota, North Dakota, Oregon, Tennessee and Wisconsin.

Holli Senior, a spokeswoman for the Pennsylvania Department of Health, said Pennsylvania hospitals are not required to specifically report CRE cases and declined to say whether any cases have been reported to the state. Pennsylvania hospitals are required to report any health care-associated infection as long as it meets the National Safety Healthcare Network criteria for a certain event type. If CRE happens to be the specific bacteria causing the infection, it would be included, she said.

“There is no reliable national data on the scope of the CRE problem,” Senior said. “Additionally, we don't have enough data to tell what the trend looks like.”

Dr. Stephen Colodny, an infectious disease physician at St. Clair Hospital in Mt. Lebanon, said he hasn't seen any cases of CRE but agreed there is potential for the bacteria to become a problem regionwide if health care workers don't follow precautions.

“The numbers aren't dramatic, but the potential for the problem is,” he said.

While not as prevalent as MRSA, a staph bacteria resistant to some antibiotics, CRE can get nasty, Frieden cautioned. Health authorities are sounding alarms because the bacteria is not responding to carbapenems, considered the antibiotics of last resort.

Dr. Arjun Srinivasan, the CDC's associate director for health care-associated infection prevention programs, said the best way for health care officials to prevent CRE infections and their spread is by properly washing hands when coming into contact with patients.

Luis Fábregas is a staff writer for Trib Total Media. He can be reached at 412-320-7998 or




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