A recent article in USA Today discussed a terrifying new superbug with origins here in North Carolina that has caused serious worries across the healthcare industry, leading to deaths in medical facilities large and small across the country. The bug, known as Carbapenem-Resistant Enterobacteriaceae, or CRE, is known for fighting off doctors’ last line of defense, carbapenem antibiotics. The bacteria are causing serious concern among those in the medical industry, especially nursing homes and small hospitals, as it tends to prey on the most vulnerable patients.
The bacteria made news this summer after a CRE strain attacked the National Institutes of Health outside Washington, D.C.; seven people ultimately died as a result. Research shows that since the first case of a CRE infection was reported in a North Carolina hospital back in 2001, there have been thousands of CRE cases throughout the country, showing up as everything from pneumonia to intestinal and urinary tract infections.
The bacteria’s resistance to even the strongest antibiotics has some worried about doctors’ ability to control the illness. Death rates among patients with CRE infections are around 40 percent, much worse than other common healthcare infections such as MRSA or C-Diff, which have been problems for places catering to the sick and elderly for decades.
Since starting in North Carolina, CREs have spread to at least 41 other states, according to the CDC. Many more cases have gone unreported given that it can be difficult to obtain a proper lab test confirming the presence of the bacteria in smaller hospitals and nursing homes. Many small medical facilities lack the capacity to identify CRE or the resources needed to isolate patients carrying the bacteria.
Surprisingly, given how serious the illness can be, there is no billing code for CRE infections under Medicare or Medicaid and there is no federal reporting requirement for the infections. This makes it hard to get a good national picture of the disease and only spotty records from around the country exist. One example is in Los Angeles County where one year of surveillance through mid-2011 turned up 675 cases at hospitals, nursing homes and clinics. In Maryland, a 2011 survey by the state health department identified 269 patients carrying CRE and estimated that up to 80 percent of the state’s hospitals had seen at least one case during the year.
Sadly, for at-risk patients in medical facilities throughout North Carolina there is little chance that a new drug will be developed to kill the CRE bacteria. Manufacturers have said they have no new antibiotics in development that are able to kill the bacteria. Moreover, there’s little financial incentive for drug companies to act given the bacteria’s ability to adapt to new drugs and become resistant to them as well.
That means it’s up to each medical facility to do what it takes to prevent the development and spread of such a deadly illness. Hospitals need to do the proper lab tests and implement procedures to ensure that their most vulnerable patients are kept safe from CRE infections.
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