Arjun Srinivasan, MD

Author – Arjun Srinivasan, MD
CDC’s Division of Healthcare Quality Promotion

Today in CDC’s March Vital Signs, we report on what could be the beginning of the end of antibiotics. Our arsenal of existing antibiotics is being overpowered by lethal germs called carbapenem-resistant Enterobacteriaceae (CRE). These germs affect people who are in or who recently had inpatient medical care. When someone gets a serious (bloodstream) infection from CRE, we have very few or no antibiotics to cure the problem. Up to half of patients will die. Adding to the concern of spread between people, CRE can spread their antibiotic-fighting weapons to other bacteria, potentially creating additional untreatable bacteria. New drugs won’t be here for many years, so we must do everything we can to preserve current antibiotics for as long as possible.

Here are other important facts to know about CRE:

• About 4% of US short-stay hospitals had at least one patient with a serious CRE infection during the first half of 2012. About 18% of long-term acute care hospitals had one. This totals almost 200 facilities.
• One type of CRE has been reported in medical facilities in 42 states .
• The most common type of CRE is also rising rapidly – there has been a seven-fold increase in its presence during the last 10 years.

So how do we stop the rise of these deadly, resistant CRE germs?

First, know that it can be done. CDC has mapped out specific guidelines that, when followed, can halt CRE infections before they become widespread in medical facilities and before they spread to otherwise healthy people in our communities. In fact, medical facilities in several states have reduced or stopped CRE rates by following CDC’s prevention guidelines. As further proof, Israel decreased CRE infection rates in all 27 of its hospitals by more than 70% in one year with a coordinated prevention program.

To learn specific steps tailored to CRE in your state, review CDC’s comprehensive CRE Prevention Toolkit, which provides CRE prevention guidelines for doctors and nurses, hospitals, long-term acute care hospitals, nursing homes, and health departments. The toolkit provides step-by-step instructions for facilities treating patients with CRE and for those not yet affected by it.

The entire medical system must act quickly to halt CRE infections before it’s too late. We cannot afford to miss this window of opportunity. Antibiotics are a shared resource and therefore preserving them is a shared responsibility. Are you doing everything that you can?