Carbapenem-Resistant 'superbugs' invade U.S. health care facilities

[Gert van der Hoek]

Deadly 'superbugs' invade U.S. health care facilities

Nov 29, 2012

CHARLOTTESVILLE, VA - The doctors tried one antibiotic after another, racing to stop the infection as it tore through the man's body, but nothing worked.

In a matter of days after the middle-aged patient arrived at University of Virginia Medical Center, the stubborn bacteria in his blood had fought off even what doctors consider "drugs of last resort."

"It was very alarming; it was the first time we'd seen that kind of resistance," says Amy Mathers, one of the hospital's infectious-disease specialists. "We didn't know what to offer the patient."

The man died three months later, but the bacteria wasn't done. In the months that followed, it struck again and again in the same hospital, in various forms, as doctors raced to decipher the secret to its spread.

The bacteria, known as Carbapenem-Resistant Enterobacteriaceae, or CRE, are named for their ability to fight off carbapenem antibiotics -- the last line of defense in the medical toolbox. And so far, they've emerged almost exclusively in health care facilities, picking off the weakest of patients.

USA TODAY's research shows there have been thousands of CRE cases throughout the country in recent years -- they show up as everything from pneumonia to intestinal and urinary tract infections. Yet even larger outbreaks like the UVA episode, in which seven patients also died, have received little or no national attention until now.

Since the first known case, at a North Carolina hospital, was reported in 2001, CREs have spread to at least 41 other states, according to the CDC. And many cases still go unrecognized, because it can be tough to do the proper laboratory analysis, particularly at smaller hospitals or nursing homes.

The doctors were seeing, in real time, a phenomenon that had worried researchers for years: the ability of CRE to share resistance genes across different members of the Enterobacteriaceae family.

We have continued to have patients with CREs that are related to this (first) event," Sifri says. "We haven't been able to close the door on this. ... I'm not sure you ever can."

USA Today