The Ascent of the Super Bugs
Dr. David Oxman, MD, Assistant Professor of Medicine, Division of Pulmonary & Critical Care Medicine at Thomas Jefferson University reviews a CDC report - see the link to the MMWR report: http://www.cdc.gov/mmwr/
Is this the end of the antimicrobial age? Probably not just yet, but in the ongoing war between man and microbe, the microbes continue to stay one step ahead. A recent report in the CDC’s March 5th, Morbidity and Mortality Weekly Report (MMWR) highlighted the growing emergency of bacteria that are resistant to nearly all currently available antibiotics. These bacteria known as carbapenem-resistant Enterobacteriaceae (CRE) are found infrequently but growing in prevalence. From 2001 to 2012 the proportion of Enterobacteriaceae that were highly antibiotic-resistant more than tripled (from 1.2% to 4.6%). The biggest risk factor for infection with these bugs is multiple health care exposures and prior receipt of antibiotics. And while nearly 5% of acute care hospitals in 2012 reported having had at least one CRE infection, nearly 18% of long-term acute care hospitals (LTACHS) reported infections with CREs. This suggests that residents of long-term health care facilities may be at the greatest risk and may be a reservoir for wider transmission. Mortality from infections with these bacteria is much higher than infections with similar more susceptible bacteria. This is partly because there are often no effective antibiotics to treat patients with these infections, and also because they tend to attack patients with multiple medical co-morbidities. New antimicrobials with activity against these highly resistant organisms are being developed but are a long way from clinical use. Until then we must focus on identification and prevention of transmission as well as vigilance against fanning the flames with the indiscriminate overuse of antimicrobials.