Ten cases of a strain of carbapenem-resistant Enterobacteriaceae — previously categorized by the director of the CDC as "nightmare bacteria" — occurred in the state of Colorado from 2014 to 2016, according to the CDC's Morbidity and Mortality Weekly Report.
Six of these reported cases were detected in outpatient settings among individuals with no known CRE risk factors like overnight hospital stays, dialysis treatment, surgery within the past year or invasive device exposure within the previous two days.
The CRE detected in the 10 Colorado patients contained the New Delhi metallo-β-lactamase enzyme, which makes the bacteria resistant to a broad range of antibiotics. This particular strain of CRE is uncommon in the U.S. and considered to be a global threat.
"The finding that 6 of 10 recent NDM-producing CRE are community-associated suggests that the epidemiology of CRE could be changing. Further surveillance is required to determine whether this pattern continues," wrote the study's authors.
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