The prevalence of Carbapenem-resistant Enterobacteriaceae, a strain of antibiotic-resistant bacteria commonly found in healthcare settings, is making inroads in major cities in the U.S., according to the CDC.
Researchers surveyed seven large metropolitan areas in the U.S. looking for CRE, and found active cases of the infection in every city they examined. Atlanta, Baltimore and New York City had higher-than-expected levels of infections from the bacteria, and Albuquerque, N.M., Denver and Portland, Ore., had lower-than-expected levels, according to the study, published in the Journal of the American Medical Association.
"Here we are with an opportunity to intervene on one of these multidrug-resistant organisms just as it's about to emerge and it's still relatively uncommon," Alexander Kallen, MD, a medical officer for the CDC, said in a statement. "That is the time you want to intervene. It's much easier to control things and prevent the organism from becoming more common when it's rare."
CRE was first reported in 2001, but has become relatively common in a short time, according to the authors. Of the 599 CRE infection cases reported in the past two years, 9 percent have been fatal. Of those cases, 75 percent occurred in people with prior hospitalizations and more than half of infection cases resulted in discharge to a long-term care setting.
Researchers have learned from other aggressive, opportunistic bacteria such as Clostridium difficile and methicillin-resistant Staphylococcus aureus, that infections can spread very quickly among patient populations administered high doses of antibiotics. Those examples may be an indicator that taking action against CRE now could prevent a much more significant problem in the near future, according to the researchers.
"If CRE gets into the community and starts causing regular old urinary tract infections in otherwise healthy people, it will have a significant impact because we don't have agents to treat those things," Mary Hayden, MD, an associate professor of pathology at Rush University Medical Center in Chicago and co-author of the paper, said in a statement.