A drug-resistant microbe called CRE is the latest in an army of superbugs that are particularly dangerous for vulnerable groups like seniors. Learn more about this superbug.
In recent months, caregivers and health professionals have been raising the alarm about a so-called “nightmare bacteria” — one of the growing class of frightening superbugs, like MRSA, that are resistant to antibiotics. Superbugs are an increasing problem, particularly in healthcare settings, where they are more easily spread between patients and other individuals sharing close quarters.
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Because of the widespread use of antibiotics in medical treatment over the past seven decades, many organisms have begun to adapt, developing antimicrobial resistance. This means the use of some drugs may be less effective in treating certain diseases. Even more alarming, notes the CDC, are those superbugs that adapt to multiple treatments: multidrug-resistant strains. The latest superbug outbreak to make headlines, carbapenem-resistant enterobacteriaceae (CRE), is resistant to nearly all antibiotics available to us today. Almost half of infected patients die once the bacterium has entered the bloodstream.
The Enterobacteriaceae are a large family of bacteria that the CDC describes as “normal inhabitants of the gastrointestinal tract of humans and other animals,” such as the familiar E. coli bacterium. They are a common cause of infection in the health care setting and the community, but it has only been over the past decade that they have begun developing antibiotic resistance. PBS Frontline reports that the resistance is related to a gene called NDM-1, which can jump between bacteria, and it thwarts almost all of our known antibiotics — including the “last-resort” antibiotics known as carbapanems.
CRE bacteria can cause a wide range of diseases when they spread outside of the gut, such as urinary tract infections, bloodstream infections, wound infections, and pneumonia. Healthy people do not normally get such infections; the likelihood is greater for those already being treated for another condition. Direct or indirect contact with an infected person is usually necessary: “CRE can cause infections when they enter the body, often through medical devices like ventilators, intravenous catheters, urinary catheters, or wounds caused by injury or surgery,” says the CDC. One large outbreak in Illinois occurred after patients underwent an endoscopic procedure.
The good news is, not everybody carrying CRE inevitably develops infection, and those people don’t require antibiotic treatment. Of course, preventing infection in the first place and promoting safe health care practices are currently the greatest weapons in our arsenal against superbugs.
Seniors and their caregivers need to be particularly vigilant about this latest superbug. Vulnerable groups such as the elderly and those already hospitalized for another condition often have lowered immunity, and are thus more susceptible to infections. According to a recent study in the Cleveland Clinic Journal of Medicine, “The clinical impact of CRE falls on elderly patients exposed to these organisms in hospitals and long-term care facilities. In this vulnerable group, invasive infections with CRE exact a high death rate.”
In other words, settings like skilled nursing facilities and hospitals can be a breeding ground for superbugs, which quickly jump from person to person in such crowded environments. This puts seniors in long-term care at greater risk of such infections, and because their immune systems may be compromised, they are also at greater risk of mortality.
CRE is on the CDC’s radar as one of the superbugs most in need of monitoring and urgent action, according to a 2013 threat report, which estimates about 9,000 cases per year and about 600 deaths. There are a number of guidelines that caregivers and seniors can follow in order to prevent CRE infections:
Wash hands with soap and water or alcohol-based sanitizer before and after handling a patient — including helping them to the bathroom. Seniors and patients should also wash their hands often: before eating, after coughing or sneezing, before and after changing bandages, etc.
Wear gloves if they expect to come into contact with bodily fluids or blood.
Make sure medical devices and rooms are clean and disinfected, and to wash hands before and after handling medical equipment.
Seniors should take antibiotics only as prescribed.
If you think you or a loved one might have CRE, consult a health care provider right away for testing. Tell them if you have been hospitalized recently in another facility, especially if you were treated in another country, as some antibiotic-resistant bacteria are more common in other countries. And, of course, follow all of your provider’s instructions for proper hygiene and antibiotic use.
Have you or a loved one ever been diagnosed or treated for a superbug like CRE? Share your stories in the comments below.
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