Tuesday, May 21, 2013

Superbug CRE Almost Untreatable


Carbapenem-resistant Enterobacteriaceae, known as CRE  is on the rise in US hospitals and nursing homes.  According To the U.S. Centers for Disease Control and Prevention. So far only 4% of the U.S. acute care facilities had cases of CRE last year. This number is expected to increase.Sense it is resistant to most antibiotics it is nearly untreatable.
 
According to the CDC “Healthy people usually do not get CRE infections. In healthcare settings, CRE infections most commonly occur among patients who are receiving treatment for other conditions. Patients whose care requires devices like ventilators (breathing machines), urinary (bladder) catheters, or intravenous (vein) catheters, and patients who are taking long courses of certain antibiotics are most at risk for CRE infections.” Many times these people have weakened immune systems.
Some CRE bacteria have become resistant to most available antibiotics. Once these CRE bacteria get into the bloodstream they can contribute to death in  50% of patients. This is a higher rate of death than MRSA Doctors are stuck treating the CRE bacteria with the antibiotic colistin which has a toxic effect on the kidneys and can damage nerves.
The CDC reported  CRE was first detected in a North Carolina hospital in 2001. Since that time, it has been identified in health care facilities in 41 other states. There was a 30% infection rate in long-term care facilities (e.g. nursing homes), though not all patients are symptomatic. During just the first half of 2012, almost 200 hospitals and long-term acute care facilities treated at least ]The increases in CRE prevalence have not been limited to the US. CRE bacteria is also on the rise in Thailand and Australia
A study conducted in the Melbourne, Australia ICU demonstrated that hand washing stations were locations CRE resistant bacteria were found . The researchers discovered.  that improper cleaning methods spread  the bacteria from sink to sink. Other sources of transmission were
failure to adequately clean and disinfect medication cabinets, other surfaces in patient rooportable medical equipment, such as X-ray and ultrasound machines that are used for both CRE and non-CRE patients.
In a recent study in Australia, researchers found  CRE resistant bacteria in ICU sinks and drains. Despite multiple attempts to sterilize these sinks and drains, using detergents and steam, hospital staff were unsuccessful in getting rid of the CRE  bacteria. Due to the bacteria's resistance to cleaning measures, staff should take extreme precaution in maintaining sterile environments in hospitals not yet infected with the CRE-resistant bacteria.Copper sinks were found to stop the spread of CRE bacteria.
The CDC has urged hospitals, health care providers and patients to take steps to curb the
spread of the dangerous superbug that include frequent hand-washing. The agency also
recommends removing intravenous lines and catheters as early as possible to reduce the risk of
infection.

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