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Nightmare superbug killing half of those who are infected says CDC

March 7, 2013

examiner.com

A nightmare gut bacteria that can kill up to 50 percent of those infected, the extremely drug-resistant Klebsiella pneumoniae carbapenemase (KPC)–producing K. pneumoniae sequence type 258 (KpnST258) has emerged as an important pathogen worldwide. Hospitals are scrambling to get rid of this bacteria. Check out the video, “Hospitals scramble to kill ‘superbug’”on NBCNews.com.

A deadly class of superbugs nearly impossible to treat with a fatality rate approaching 50 percent need to be stopped. But how do scientists stop the CRE outbreaks from reaching the general public? The Centers for Disease Control (CDC) has identified deadly ‘nightmare’ bacteria that’s resistant to antibiotics and spreading through the nation’s hospitals. There’s the potential for CRE bacteria to spread to patients with common ailments such as diarrhea or more severe infections such as pneumonia. The doctors don’t have any drug to treat CRE outbreaks because the bacteria is resistant to what’s currently available.

Nightmare superbug killing half of those who are infected says CDC.
Nightmare superbug killing half of those who are infected says CDC.
Photo credit:
Pork cut into cubes and purchased at a local discount supermarket lies on a plate in this photo illustration on February 8, 2012 in Berlin, Germany. (Photo Illustration by Sean Gallup/Getty Images).

Could the bacteria spread to food?

The online edition of Stern magazine announced on February 8, 2013 that lab analyses of 20 different samples of pork purchased at different supermarkets nationwide (in Germany not in the USA) showed mutated forms of the bacteria escherichia coli in five of the samples. The bacteria contains ESBL, an enzyme the magazine claims makes many antibiotics ineffective. What happens if drug-resistant bacteria in food gets into the digestiv systems of hospital or nursing home patients and then spreads to the general public?

Germany’s Ministry of Agriculture and Consumer Protection recently announced its intent to force farmers to reduce the amount of antibiotics given to livestock, a practice most scientists agree increases the likelihood of bacteria mutating into antibiotic-resistant forms. Can a similar scenario happen in other countries, including the USA? The drug-resistant CRE bacteria in the digestive systems of hospital and nursing home patients has been found in the USA.

It’s now called the nightmare superbug. The CRE superbug already has spread in the United States and in various countries in Europe and Asia, according to reports from the Centers for disease control (CDC). Check out the PDF site, “Deadly ‘superbugs’ invade U.S. health care facilities.” And take a look at the article, “Emergence of Carbapenem-Resistant Enterobacteriaceae.”

The so-called nightmare CRE bacteria is found in the human digestive system

CRE can be spread by people not washing their hands thoroughly and then touching catheters and ventilators that go deep inside the body of a hospital or nursing home patient. The nightmare is about how to stop it from spreading through hospitals and nursing homes and then to the public since the bacteria is resistant to anti-biotics. Can it also spread to other species? More research needs to be done.

Hospitals and nursing homes need to take action against the spread of a deadly, antibiotic-resistant strain of bacteria, says the Centers for Disease Control and Prevention. The bacteria kill up to half of patients who are infected. Check out the March 6, 2013 news article, “CDC says ‘nightmare bacteria’ CRE superbug killing half of those who are infected.” Could it spread to hotels and buffets as sometimes is encountered with the norovirus and other gut infections billions of people encounter each year.

The bacteria is resistant to drugs and has a 50% fatality rate when it infects someone

Mainstream media has named this the nightmare bacteria. The high level of antimicrobial drug resistance in this bacterium is conferred by a plasmid-encoded KPC, which confers resistance to all cephalosporins, monobactams, and carbapenems.

Infection with the bacteria known as “carbapenem-resistant K. pneumoniae” is associated with an increased proportion of deaths compared to another bacteria type known as carbapenem-susceptible K. pneumoniae. Although Klebsiella with plasmid-mediated carbapenem resistance is a major risk to hospitalized patients, spread of these resistance plasmids into Escherichia coli poses an even greater public health threat because resistant E. coli may become part of the normal gut flora and then become a notable source of infections.

Where the nightmare superbug can be found

The nightmare bacteria can appear among sick and the healthy persons in healthcare settings and in the community. This bacteria may be able to change other types of bacteria to make them more anti-biotic drug-resistant.

The bacteria, called carbapenem-resistant Enterobacteriaceae or CRE, have increased its infections during the past decade and grown resistant to even the most powerful antibiotics, according to the CDC. In the first half of 2012, 200 health care facilities treated patients infected with CRE, according to the March 6, 2012 news article, “CDC: ‘Nightmare bacteria’ spreading – CNN.com.”

Nightmare bacteria thrives in the digestive system

In a study from 2008, a carbapenem-nonsusceptible E. coli–producing KPC-3 isolate (Eco2) was identified in Tel Aviv Sourasky Medical Center in Israel. Until this case, carbapenem resistance in E. coli at the hospital was related exclusively to KPC-2 production . KPC production in E. coli remains rare worldwide, even in areas where KPC-producing K. pneumoniae isolates are identified. Researchers in the 2008 study aimed to investigate the origin of KPC-3 in this E. coli isolate. For further information, see the site, “Emergence of Carbapenem-Resistant Enterobacteriaceae.”

How the anti-biotic resistant emerging bacteria was found

One study was done back in in April 2008, when a carbapenem-nonsusceptible E. coli strain, marked as Eco2, was recovered from the gall bladder drainage of a 91-year-old man with dialysis-dependent end-stage renal disease, congestive heart failure, anemia, and peptic ulcer disease. A month earlier, the patient had been hospitalized with sepsis that developed after an infected heel wound had required amputation of the left leg below the knee.

The patient was treated with ertapenem, metronidazole, colistin, and vancomycin. Acute cholecystitis developed, and the patient underwent cholecystostomy. During his hospital stay, the patient underwent screening for carriage of carbapenem-resistant Enterobacteriacae (CRE) as part of a routine infection control program aimed at limiting the spread of CRE.

Rectal swabs found the drug-resistant bacteria in the man’s digestive system as resesarchers worry about interspecies genetic transfer events

It took a month of testing to find the bacteria after a man had a cholesystectomy. Two rectal swabs were collected 1 week apart. The first swab specimen was negative for CRE by culture, and the second swab specimen showed a carbapenem-resistant K. pneumoniae strain (marked Kpn1), which was PCR positive for blaKPC. One month after the patient’s admission, a carbapenem-nonsusceptible E. coli (Eco2) was isolated from drainage at the cholecystectomy site, which prompted this study.

The researchers wanted to find out whether the patient’s gut was colonized with a carbapenem-susceptible E. coli strain. The outcome of the study suggested from the data suggested that Eco1 has acquired pKpQIL from Kpn1 in the patient’s gut, leading to the formation of Eco2. And the isolation of an isogenic, antimicrobial drug–susceptible E. coli clone enabled researchers to decipher the natural order of the interspecies genetic transfer event.

 

Increasing global spread of the nightmare bacteria.

With increasing global spread of KPC-producing K. pneumoniae ST258, the likelihood increases of interspecies transfer of drug-resistance determinants into a highly fit E. coli clone. Such an event may have severe public health consequences, leading to elimination of any effective antimicrobial drug treatment against the most common human bacterial pathogens.

Check out the 2008 study that was performed in partial fulfillment of the requirements for the MS degree at the M.G.G., Sackler Faculty of Medicine, Tel Aviv University, Israel. Author of the 2008 study is Mrs Goren, a researcher and at that time, a master’s degree candidate in the Molecular Epidemiology and Antibiotic Resistance Laboratory in Tel Aviv Medical Center. Her primary research focus in that study was the characterization of the molecular epidemiology of carbapenem resistance among Escherichia coli clinical isolates.

The world’s strongest antibiotics don’t work and patients are left with potentially untreatable infections

Today, doctors, hospital leaders and public health must work together now to implement CDC’s ‘detect and protect’ strategy and stop these infections from spreading. The problem it gets back to is hand washing of the type that people actually follow, hot water and soap. People may be handling ventilators and catheters with unwashed hands or plastic gloves that have touched other objects that have the bacteria on them.

Patients should also be screened for CREs, according to the CDC. Infected patients should be isolated, or grouped together to limit exposures. The big problem is that the bacteria in nursing homes can spread to people visiting patients on holidays. And the problem in hospitals is that it can spread to the sickest patients who have weak immune systems and then brought home on someone’s hands that have not been washed clean enough.

So far, the nightmare bacteria, CRE is seen relatively infrequently in most U.S. facilities

At the present time, the type of surveillance systems haven’t been able to find it commonly in otherwise healthy people in the community. But if it ever gets out of those nursing homes and hospitals, it would be a nightmare to control, considering how many people handle food or cut up vegetables bought by the public. But the real nightmare is the bacteria getting on catheters and on ventilators that go deep inside the human body of patients, some who have weakened immune systems, and others recovering from surgery or various invasive tests.

Half the patients die who are infected with CRE. The CDC reports that up to 50% of patients with CRE bloodstream infections die. But similar antibiotic-susceptible bacteria kill about 20% of bloodstream-infected patients. The big issue is how to prevent the nightmare bacteria from getting into the bloodstream in the first place. There’s also the skin-infecting MRSA bacteria with which hospitals are trying to cope, Check out the article, “CDC says ‘nightmare bacteria’ CRE superbug killing half of those who are infected.

CDC: Deadly, drug-defying CRE bacteria on rise in U.S. hospitals

CDC Warns Of Spread Of Deadly Antibiotic-Resistant Bacteria

Infections With ‘Nightmare Bacteria’ Are On The Rise In U.S. – NPR

‘Nightmare’ Bacteria Spreading in U.S. Hospitals, Nursing Homes

CDC says ‘nightmare bacteria’ CRE superbug killing half of those

Carbapenem resistant enterobacteriaceae – Wikipedia

Carbapenem-resistant Enterobacteriaceae – Utah Department of Public Health

Nightmare bacteria, shrugging off antibiotics, on rise in U.S. | Reuters

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