A warning from the Centers for Disease Control and Prevention that infections from carbapenem-resistant enterobacteriaceae (CRE) are spreading in health facilities received extensive coverage in print and online, and was featured on one of last night's national news broadcasts. Most sources quote Thomas Frieden, director of the Centers for Disease Control and Prevention, who referred to CRE as "nightmare bacteria." Frieden, along with other CDC officials, urged hospitals to take steps to prevent CRE infections. The CBS Evening News (3/5, story 9, 0:25, Pelley, 5.58M) reported that "The CDC is warning...of a serious and growing health risk inside hospitals: newly discovered super bugs that resist even the strongest antibiotics."
USA Today (3/5, Szabo, Eisler, 1.71M) reports, "So far, this particular class of superbug, called carbapenem-resistant Enterobacteriaceae, or CRE, has been found only in hospitals or nursing homes, rather than in the community, Frieden said." According to Frieden, "These are nightmare bacteria that present a triple threat." He added, "They're resistant to nearly all antibiotics. They have high mortality rates, killing half of people with serious infections. And they can spread their resistance to other bacteria."
The New York Times (3/6, Grady, Subscription Publication, 1.68M) reports, "According to a new report by the disease centers, among all infections with gut bacteria, the proportion caused by carbapenem-resistant types rose to 4 percent in 2012, from 1 percent in 2001; among infections caused by one type of bacteria, Klebsiella, 10 percent have become resistant, compared with 2 percent a decade ago." Frieden "noted that they could pass their trait for drug resistance - encoded in a scrap of genetic material called a plasmid - along to other bacteria."
The Washington Post (3/6, Sun, 489K) reports that Frieden "said at a news conference: 'It's not often that our scientists come to me and say we have a very serious problem and we need to sound an alarm. But that's exactly what we are doing today.'" Frieden "called on doctors, hospital leaders and health officials to work together to stop the spread of the infections."
The Wall Street Journal (3/6, Landro, Subscription Publication, 2.29M) reports that Frieden said, "Our strongest antibiotics don't work and patients are left with potentially untreatable infections." Meanwhile, in an interview, Arjun Srinivasan, the associate director for health-care-associated infection prevention programs at the CDC, said, "We believe there is an opportunity to act now to control these resistant bacteria before it becomes a bigger problem."
The AP (3/6, Stobbe) reports, "The bacteria usually live harmlessly in the gut but can cause pneumonia, and urinary tract and bloodstream infections if they get into other parts of the bodies of patients with weakened immune systems. As many as half the patients who get the bloodstream infections die, Srinivasan said."
The Los Angeles Times (3/5, Khan, 692K) "Booster Shots" blog reports that CRE is "especially problematic in long-term acute-care hospitals - 18% of them had at least one CRE infection in the first six months of 2012, according to the CDC. One such hospital in Florida reportedly had a whopping 44% infection rate."
McClatchy (3/6, Pugh) reports, "A strain of the superbug killed seven patients in 2011 at the National Institutes of Health Clinical Center in Bethesda, Md., but the deaths were not disclosed until 2012." According to McClatchy, "In their wake, the CDC issued recommendations for health care facilities to stop the spread of the bacteria, and many saw dramatic declines in CRE infections as a result, Frieden said." However, "many facilities haven't adopted the recommendations, and the bacteria continue to spread."
Bloomberg News (3/6, Lopatto) reports, "To prevent the germs from spreading from hospitals into the community at large, the CDC recommends testing for CRE and keeping patients with the infection in specialized wards with dedicated staff. Handwashing among hospital staff is particularly important, Frieden said."
On its website, CBS News (3/6) reports that according to Dr. Michael Bell, acting director of CDC's Division of Healthcare Quality Promotion, "We have seen in outbreak after outbreak that when facilities and regions follow CDC's prevention guidelines, CRE can be controlled and even stopped." Dr. Bell added, "As trusted health care providers, it is our responsibility to prevent further spread of these deadly bacteria."
The NPR (3/5, Stein) "Shots" blog reports, "Although the resistant bacteria potentially pose a risk to anyone, people whose immune systems are weaker, such as elderly people, children and people who have other health problems, tend to be most susceptible to infection."
CQ (3/6, Adams, Subscription Publication) reports that CDC "officials said that six states require facilities to conduct testing for it through mandatory reporting rules." Agency "officials recommend that hospitals perform routine testing in geographic areas where it is commonly found." Thus "far, the problem has not been seen outside of medical facilities, Frieden said, 'and it's important we keep it that way.'"
The Milwaukee Journal Sentinel (3/6, 221K) reports, "Wisconsin is among the first six states to require facilities to report infections associated with the superbug, though the surveillance is still new and many hospitals and long-term acute care facilities may not be aware of it, said Gwen Borlaug, coordinator of the state program that monitors health care associated infections." Meanwhile, "Milwaukee is one of four cities around the country piloting a regional collaboration for CRE surveillance and prevention through a contract with the National Association of County and City Health Officials." Milwaukee "was chosen for the surveillance pilot because it already has a strong network that links public health officials with all types of health care facilities."
The Pittsburgh Tribune-Review (3/6, Fábregas, 194K) reports, "The largest number of facilities reporting CRE infections, 63, were in the Northeast region, which includes Pennsylvania and eight other states, the agency said." The Tribune-Review adds "Also reporting CRE cases were 50 facilities in the South, 30 in the Midwest, 29 in the West and nine in other locations, including Puerto Rico, the Virgin Islands and among the armed forces."
Reuters (3/6, Begley) pointed out that according to Dr. Srinivasan, CRE "is prevalent in a number of hospitals in the New York area."
Minnesota Public Radio (3/5, Benson) reports, "State Health Department epidemiologist Kristin Shaw said in 2011 Minnesota had 44 CRE infections among hospitalized patients. That figure more than doubled in 2012, rising to 90 cases." Also covering the story are the Boston Globe (3/6, Kotz, 250K) "Daily Dose" blog, Modern Healthcare (3/5, McKinney, Subscription Publication, 71K),Medscape (3/6), MedPage Today (3/6, Gever), and HealthDay (3/6, Reinberg).
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