It is not pandemic, not yet, but the spread of a particular form of drug resistant bacteria is serious enough to warrant this March 6 statement from Dr. Thomas Frieden the head of the United States Centers for Disease Control and Prevention (CDC):
CRE poses a triple threat. First, they’re resistant to all or nearly all antibiotics. Even some of our last-resort drugs. Second, they have high mortality rates. They kill up to half of the people who get serious infections with them. And third, they can spread resistance to other bacteria. So one form of bacteria, for example, carbapenem-resistant Klebsiella, can spread the genes that destroy our last antibiotics to other bacteria, such as E. coli, and make E. coli resistant to those antibiotics also… We only have a limited window of opportunity.
[Source: CDC: Action needed now to halt spread of deadly bacteria]
CRE is the acronym for the tongue twisting carbapenem-resistant Enterobacteriaceae, where carbapenem is one of the major antibiotic groups of last resort and Enterobacteriaceae is a large family of seventy gut-dwelling bacteria (including the ever present forms of Escherichia coli – E. coli, Klebsiella, Salmonella and Shigella). These are bacteria generally present in the human digestive system, often kept at low and relatively harmless levels by natural defenses. However, for people whose immune systems are weakened or in situations where more virulent forms of the bacteria are present – these bacteria can become killers.
Unfortunately, one of the places where this is most likely to happen is in hospitals, particularly in intensive care units (ICU). These drug resistant bacteria like the ‘sterile’ plastics, tiles and metals of the hospital environment. It’s also where they are routinely exposed to a variety of antibiotics, all the better for their adaptation to resist them.
The CRE bacteria also thrive in many critical care institutions – nursing homes, rehab units – where patients are weakened, immunologically compromised, exposed to many outsiders and where they often contract diarrhea, the most potent mode of distribution for bacteria. Given these characteristics CRE spread easily. So far, they have been diagnosed in 42 of the United States and in many countries around the world. The numbers are increasing with 4.6 percent of U.S. hospitals and 17.8 percent of long-term care facilities reporting cases in 2012.
This is not epidemic or pandemic level – not yet. But given the way this particular drug resistance spreads, it seems like only a matter of a few years before it becomes common and epidemic. Remember, IT CANNOT BE TREATED with drugs and IT KILLS. These words are in capitals, not because typed shouting is cool, but because the danger is real and, for the most part, not much is being done about it. The CDC is pushing a non-funded, voluntary reporting system for CRE in the United States. Among other countries, only Israel has an all-out national program against CRE.
So it can’t be that bad, can it? We’ll see.
