Lethal, Drug-resistant Bacteria Spreading in U.S. Healthcare Facilities

Publication/Release Date February 2013

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Drug-resistant germs called carbapenem-resistant Enterobacteriaceae, or CRE, are on the rise and have become more resistant to last-resort antibiotics during the past decade, according to a new CDC Vital Signs report.  These bacteria are causing more hospitalized patients to get infections that, in some cases, are impossible to treat.

CRE are lethal bacteria that pose a triple threat:

  • Resistance: CRE are resistant to all, or nearly all, the antibiotics we have – even our most powerful drugs of last-resort.
  • Death: CRE have high mortality rates – CRE germs kill 1 in 2 patients who get bloodstream infections from them.
  • Spread of disease:  CRE easily transfer their antibiotic resistance to other bacteria.  For example, carbapenem-resistant klebsiella can spread its drug-destroying weapons to a normal E. coli bacteria, which makes the E.coli resistant to antibiotics also. That could create a nightmare scenario since E. coli is the most common cause of urinary tract infections in healthy people.

Currently, almost all CRE infections occur in people receiving significant medical care.  CRE are usually transmitted from person-to-person, often on the hands of health care workers.  In 2012, CDC released a concise, practical CRE prevention toolkit with in-depth recommendations to control CRE transmission in hospitals, long-term acute care facilities, and nursing homes.  Recommendations for health departments are also included.  CRE can be carried by patients from one health care setting to another.  Therefore, facilities are encouraged to work together, using a regional “Detect and Protect” approach, to implement CRE prevention programs.

In addition to detailed data about the rise of CRE, the Vital Signs report details steps health care providers, CEOs and chief medical officers, state health departments and patients can take now to slow, and even stop, CRE before it becomes widespread throughout the country.

SAVE THE DATE: Chat with CDC Director Tom Frieden on CRE and other healthcare-associated infections, March 25, 2013, 2 p.m. ET​

CRE germs kill up to half of patients who get bloodstream infections from them

CRE germs kill up to half of patients who get bloodstream infections from them

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4% & 18% - About 4% of the 4,000 US hospitals studied had at least one patient with a serious CRE infection during the first half of 2012. About 18% of the country’s 200 long-term acute care hospitals had one. This totals nearly 200 facilities with at least one CRE patient in six months.

4% & 18% - About 4% of the 4,000 US hospitals studied had at least one patient with a serious CRE infection during the first half of 2012. About 18% of the countrys 200 long-term acute care hospitals had one. This totals nearly 200 facilities with at least one CRE patient in six months.

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How CRE takes over

How CRE takes over

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Klebsiella pneumoniae

Klebsiella pneumoniae

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CDC's Kitty Anderson holds up a 96-well plate used for testing the ability of bacteria to growth in the presence of antibiotics.

CDC's Kitty Anderson holds up a 96-well plate used for testing the ability of bacteria to growth in the presence of antibiotics.

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CDC staff show two plates growing bacteria in the presence of discs containing various antibiotics. The isolate on the left plate is susceptible to the antibiotics on the discs and is therefore unable to grow around the discs. The one on the right has a CRE that is resistant to all of the antibiotics tested and is able to grow near the disks.

CDC staff show two plates growing bacteria in the presence of discs containing various antibiotics. The isolate on the left plate is susceptible to the antibiotics on the discs and is therefore unable to grow around the discs. The one on the right has a CRE that is resistant to all of the antibiotics tested and is able to grow near the disks.

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CDC's Tatiana Travis sets up real-time polymerase chain reaction (PCR) test to detect drug-resistant pathogens, including CRE.

CDC's Tatiana Travis sets up real-time polymerase chain reaction (PCR) test to detect drug-resistant pathogens, including CRE.

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CDC microbiologist, Tatiana Travis, sets up real-time polymerase chain reaction (PCR) test to detect drug-resistant pathogens, including CRE.

CDC microbiologist, Tatiana Travis, sets up real-time polymerase chain reaction (PCR) test to detect drug-resistant pathogens, including CRE.

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CDC microbiologist, Kitty Anderson, looks at a 96-well plate used for testing the ability of bacteria to growth in the presence of antibiotics.

CDC microbiologist, Kitty Anderson, looks at a 96-well plate used for testing the ability of bacteria to growth in the presence of antibiotics.

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CDC microbiologist, Johannetsy Avillan, holds up a plate that demonstrates the modified Hodge test, which is used to identify resistance in bacteria known as Enterobacteriaceae. Bacteria that are resistant to carbapenems, considered last resort antibiotics, produce a distinctive clover-leaf shape.

CDC microbiologist, Johannetsy Avillan, holds up a plate that demonstrates the modified Hodge test, which is used to identify resistance in bacteria known as Enterobacteriaceae. Bacteria that are resistant to carbapenems, considered last resort antibiotics, produce a distinctive clover-leaf shape.

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CDC microbiologist, Kitty Anderson, looks at a 96-well plate used for testing the ability of bacteria to grow in the presence of antibiotics.

CDC microbiologist, Kitty Anderson, looks at a 96-well plate used for testing the ability of bacteria to grow in the presence of antibiotics.

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CDC microbiologist, Johannetsy Avillan, holds up a plate that demonstrates the modified Hodge test, which is used to identify resistance in bacteria known as Enterobacteriaceae. Bacteria that are resistant to carbapenems, considered last resort antibiotics, produce a distinctive clover-leaf shape.

CDC microbiologist, Johannetsy Avillan, holds up a plate that demonstrates the modified Hodge test, which is used to identify resistance in bacteria known as Enterobacteriaceae. Bacteria that are resistant to carbapenems, considered last resort antibiotics, produce a distinctive clover-leaf shape.

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CDC microbiologist, Alicia Shams, demonstrates Klebsiella pneumoniae growing on a MacConkey agar plate. Klebsiella pneumoniae is the most common Enterobacteriaceae that is drug resistant.

CDC microbiologist, Alicia Shams, demonstrates Klebsiella pneumoniae growing on a MacConkey agar plate. Klebsiella pneumoniae is the most common Enterobacteriaceae that is drug resistant.

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Contact Information

CDC Media Relations
(404) 639-3286
media@cdc.gov

Vital Signs Links

Factsheet:
English pdf icon[PDF – 4 pages]

Spokespersons

Biography

Photo: Michael Bell, MD

“We have seen in outbreak after outbreak that when facilities and regions follow CDC’s prevention guidelines, CRE can be controlled and even stopped. As trusted health care providers, it is our responsibility to prevent further spread of these potentially deadly bacteria.”

Michael Bell, MD – Acting Director of CDC’s Division of Healthcare Quality Promotion

Biography

Arjun Srinivasan, MD

“Now is the time to act. We have prevention recommendations – they just need to be enacted. We must tackle these bugs before they become widespread.”

Arjun Srinivasan, MD – Associate Director for Healthcare Associated Infection Prevention Programs, Division of Healthcare Quality Promotion, US Centers for Disease Control and Prevention

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Page last reviewed: August 9, 2018
Content source: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality Promotion (DHQP)