The prevalence of carbapenem-resistant Enterobacteriaceae (CRE) seems to be growing, says Maryn McKenna, reporting on a new study. From 2008 to 2012, in the American southeast, the rate of detection of the bacteria increased five-fold. Most of these cases (288 of 305, or 94 percent) were connected to hospital visits, but some weren't. Some of this five-fold increase is attributable to better detection methods, the scientists say, but some of it is a sign that these antibiotic-resistant bacteria are taking hold.
"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."
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.
Anderson said rates have probably risen just as much nationally at small community hospitals, "which are the main type of hospitals in the U.S."
CRE-related illnesses vary by where the germ infects the body and range from gastrointestinal illness 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.
If the spread of CRE isn't prevented, "we'll be in a post-antibiotic era," said Kevin Kavanagh, an infection-control activist who leads the watchdog group Health Watch USA in Somerset, Ky. "And the danger is not going to go away unless we change the course of how we do things."
Despite the prevalence of antibiotic-resistant genes in nature, GWU epidemiologist Lance Price said that the growing threats in human medicine are largely rooted in human misuse of antibiotics, and that the solutions lie in human hands.
In September, the Centers for Disease Control and Prevention warned that the nation faces “potentially catastrophic consequences” if it does not move rapidly to counter the growing threat of antibiotic-resistant infections, which sicken about 2 million Americans and kill an estimated 23,000 each year.
The agency noted that the overuse of antibiotics is the strongest contributing factor to the surge in resistance around the world — the more germs are exposed to an antibiotic, the more they are able to build resistance to it — and it has pushed for doctors and hospitals to be more judicious in their prescribing of the drugs.
At the same time, the overwhelming majority of antibiotics in the United States are used in animal agriculture, both to promote growth and to treat and prevent disease in livestock. In December, the Food and Drug Administration asked the agricultural industry to voluntarily phase out the use of certain antibiotics in livestock and prevent their use merely to boost animal growth. The move was intended to address long-standing fears that the massive amounts of antibiotics being used on farms were making those medications less effective over time.
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