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April 2013 Clinical Laboratory News: Volume 39, Number 4


CDC Warns of Drug-Resistant Bacteria

Hospitals need to be on the lookout for a nearly untreatable, deadly bacteria, according to a report from the Centers for Disease Control and Prevention (CDC). Though spreading slowly in the U.S., the bacteria, Carbapenem-resistant Enterobacteriaceae (CRE), is lethal in about 40% of cases.

CDC issued a health advisory over its Health Alert Network after new data published in Morbidity and Mortality Weekly Report showed a fourfold increase in the number of drug-resistant Enterobacteriaceae over the past decade (2013;62:165–70). One type of CRE, a resistant form of Klebsiella pneumoniae, has shown a sevenfold increase in the last decade. During the first half of 2012, almost 200 hospitals and long-term acute care facilities treated at least one patient infected with CRE, CDC researchers found.

While CDC found that the bacteria have now spread throughout the U.S., in most areas they remain relatively uncommon. Currently, almost all CRE infections occur in people receiving significant medical care in hospitals, long-term acute care facilities, or nursing homes. The northeastern states report the most cases of CRE.

However, CRE could spread into the community among otherwise healthy people, according to CDC. In addition to spreading among patients, CRE bacteria can transfer their resistance to other bacteria within their family. This type of spread can create additional life-threatening infections for patients in hospitals and potentially for otherwise healthy people. Enterobacteriaceae are already a common cause of community infections.

To prevent the spread of CRE before the bacteria gain a foothold in more hospitals or the community, CDC urged active case detection and contact precautions for colonized or infected patients, appropriate antibiotic use in all settings, and communication about infections when patients transfer.

CDC created a CRE toolkit in 2012 with specific advice on laboratory screening and other infection control mechanisms which is available online.

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