'Nightmare bacteria' superbug spreads in Southeast
Superbugs known as CRE — called “nightmare bacteria” by federal health officials because they are deadly and virtually untreatable — are skyrocketing in the Southeastern United States, research shows. Experts fear a growing national problem, and some say the spread of such superbugs may portend a “post-antibiotic era.”
Cases of the antibiotic-resistant CRE rose fivefold in community hospitals in the region from 2008 to 2012, researchers at Duke University Medical Center found, and they said those rates are likely underestimates.
“We're trying to sound the alarm. This is a problem for all of us in health care,” said Deverick J. Anderson, senior author of the study and an associate professor of medicine at Duke. “These (bacteria) are just about as bad as it gets.”
CRE, short for carbapenem-resistant Enterobacteriaceae, are a family of bacteria that have over time become resistant to last-resort antibiotics. They prey on vulnerable, hospitalized patients and kill nearly half who get bloodstream infections.
CRE are the worst of the worst in a growing sea of pernicious germs resistant to antibiotics that take hold in sick patients in health care settings. According to the Centers for Disease Control and Prevention, one in 25 hospitalized patients has at least one health care-associated infection on any given day.
Two of the more common superbugs are C. difficile, which is rising steeply and is linked to about 14,000 American deaths each year, and MRSA, which has been a problem in hospitals for decades. Researchers point to a recent decrease in invasive MRSA infections but estimate there were still more than 80,000 in 2011. MRSA has spread beyond hospitals into communities.
The emergence and spread of these superbugs could be fueled by the overuse of antibiotics and gaps in infection control in hospitals and long-term care facilities.
Lapses occur even though hospitals and government health agencies educate doctors and other health care workers about hand-washing and room-cleaning. Activists said doctors turn too often to antibiotics for sore throats, coughs or other common ailments.
“That needs to stop,” said Kevin Kavanagh, an infection-control activist who leads the watchdog group Health Watch USA in Somerset, Ky.
The federal government does not track individual cases, but the CDC issued warnings last year about CRE, saying the bacteria spread from one medical facility in 2001 to numerous facilities in 46 states in 2013. CDC Director Tom Frieden, who dubbed them “nightmare bacteria,” said, “Our strongest antibiotics don't work, and patients are left with potentially untreatable infections.”
Anderson's study, in the current issue of the journal Infection Control and Hospital Epidemiology, found the CRE detection rate rose more than fivefold within the Duke Infection Control Outreach Network, a cluster of 25 community hospitals in North Carolina, South Carolina, Virginia and Georgia.
CRE-related illnesses vary by where the germ infects the body and range from gastrointestinal illnesses to pneumonia to bloodstream infections. Though all superbug infections are difficult to treat, CRE is among the least treatable and deadliest.
“We're really just running out of (treatment) options,” Anderson said.