Researchers from Massachusetts have found that carbapenem-resistant Enterobacteriaceae have more genetic traits that enable antibiotic-resistance than previously thought and these traits are easily transferred among species.
As reports of superbugs—bacteria that are resistant to most, if not all antibiotics—continue to pop up around the world, scientists continue to learn about these dangerous pathogens. New research out of the Harvard TH Chan School of Public Health, the Broad Institute at the Massachusetts Institute of Technology, and Harvard University, is particularly troubling as scientists have found that a family of superbugs, carbapenem-resistant Enterobacteriaceae (CRE), may actually be spreading more than experts previously thought.
According to a recent press release, after examining 250 samples of CRE in four US hospitals (three hospitals from the Boston area and one from California), researchers found a wide variety of CRE species with “a wide variety of genetic traits enabling [them] to resist antibiotics.” In addition, the researchers “found that these traits are transferring easily among various CRE species.”
What makes these findings particularly alarming is that they “suggest that CRE is more widespread than previously thought, that it may well be transmitting from person to person asymptomatically.” Indeed, previous research has even found carbapenem-resistant bacteria in air pollution.
According to the Centers for Disease Control and Prevention (CDC), CRE infections account for 9,300 infections and 600 deaths in the United States each year, and, as indicated in the press release, “Tom Frieden, director of the CDC, has called these 'nightmare bacteria' because they are resistant to some of the last-ditch treatments available to doctors battling resistant infections.”
Perhaps even more alarming than the findings of genetic diversity among the species of CRE is the fact that the researchers found “resistance mechanisms that hadn't been seen before—implying that there are more to be discovered.” As such the researchers note that their findings “highlight the need for vigilance in searching for as yet unknown forms of resistance as they evolve and emerge.”
CRE infections are not just confined to the United States. Recent research presented at ID Week in 2016 highlighted the fact that these infections are spreading extensively throughout the Americas and Europe. Researchers continue to find new ways to help curb these dangerous infections such as implementing antibiotic stewardship programs and the creation of disposable forms of once-reusable products that are known to contribute to the spread of these types of infections, such as endoscopes.
Additionally, Susan Kline, MD, MPH, associate professor of medicine in the Division of Infectious Diseases and International Medicine, and medical director for Infection Control, and lead physician for Antibiotic Stewardship at the University of Minnesota spoke with Contagion™ on reducing the use of carbapenems “so that we don’t select for further [CRE].”
Measures to stop these infections from occurring in the first place are also of utmost importance. According to the CDC, healthcare practitioners “play a critical role in slowing the spread of CRE.” Because CRE infections are most common in hospitals, all personnel in the facility should be made aware of which patients are infected, and special care and attention should be used to identify those patients with CRE infections to ensure the proper infection control measures are followed.