The findings of a new study highlight the potential risks associated with carbapenem-resistant Enterobacteriaceae (CRE) infections, as the antibiotic-resistant “superbug” often carries no symptoms and can be spread between patients undetected.
Researchers from Harvard and MIT studied four cases of CRE infections sampled from three hospitals in the Boston-Area and one hospital located in Irvine, California.
According to findings published in the medical journal Proceedings of the National Academy of Sciences this week, CRE may be spreading much more widely than previously thought.
Researchers tested 250 samples from patients who had CRE and found eight species were resistant to antibiotics. They also documented identical genes in different species and found two cases of high-level resistance they could not explain.
The study suggests that patients are colonizing the germs without exhibiting symptoms and then spreading it to other patients without becoming sick themselves. In fact, most patients won’t have any symptoms, researchers note.
The CRE bacteria lives in the intestinal tract, but can infect nearly any part of the body. When symptoms are present, they range from fever, chills, headaches to general weakness.
CRE is the most resistant bacteria and is often given the strongest drugs, typically as a last resort when other common drugs fail to rid the patient of the infection. Sometimes the bacteria still thrives after being treated with antibiotics, which can lead to the development of greater resistance.
An estimated 9,300 people are infected with CRE every year in the U.S., resulting in about 600 deaths. People who are frail or have compromised immune systems face the most risk of infection.
Researchers called it “one of the most severe threats to the antibiotic era,” and in 2015 the CDC called CRE an emerging threat to the healthcare system. The CDC’s findings indicated higher-than-expected numbers of CRE in major U.S. cities.
Researchers call for aggressive approaches to detection and surveillance, including patient isolation. They noted the Dutch have one of lowest rates of antibiotic resistance of all developed countries. This is likely because they screen patients who are at risk before they are admitted to the hospital.
The study calls on the U.S. to follow suit and ask patients at intake about their history of exposure and traveling to areas of high incident rates of CRE. If they are considered to be at risk, they should be separated or quarantined from other patients to prevent the spread of the bacteria.
A study published last year concluded 1 in 7 hospital patients are infected with antibiotic-resistant bacteria. A report published by the British government last year also warned that more than 10 million deaths every year will be attributable to superbugs by the year 2050, unless drastic measures are taken to mitigate the risk.