CRE Bacteria Infection
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
- What is CRE?
- What causes CRE infections? How is CRE transmitted?
- How do CRE bacteria develop?
- What are symptoms and signs of CRE infections?
- How do doctors diagnose a CRE infection?
- What is the treatment for CRE infections?
- Is it possible to prevent a CRE infection?
- What is the prognosis of CRE infections?
What is CRE?
CRE (carbapenem-resistant Enterobacteriaceae) bacteria are members of related bacterial genera that are commonly found almost everywhere in the world, often colonizing humans and animals (living in or on humans and animals mucosal surfaces, gastrointestinal tracts, and on some areas on the skin). However, CRE possess a unique genetic makeup that allows the bacteria to make an enzyme that protect CRE bacteria from a powerful antibiotic: carbapenem. The most notable genera that can share and even transfer this genetic trait to other members of the Enterobacteriaceae are E. coli and Klebsiella pneumoniae. Because these bacteria generate similar problems for patients (especially treatment difficulties), most investigators simply group them together and term them CRE bacteria (some researchers term those bacteria that produce the enzyme carbapenemase CP-CRE bacteria). Similar types of components are termed KPC (Klebsiella pneumoniae carbapenemase) and NDM (New Delhi metallo-beta-lactamase).
In February 2015, UCLA Ronald Regan Medical Center in California reported that two patients died and five others were infected with the drug-resistant superbug CRE. An additional 179 patients may have been exposed to the bacteria. These potential exposures to this bacterium likely came from contamination of an endoscope used to treat pancreaticobillary diseases at the facility.
News agencies have presented short but eyebrow-raising comments made by the Centers for Disease Control and Prevention (CDC) about new and "dangerous" bacteria. The bacteria go by many names in the public press; "superbug 2013," "nightmare bacteria," and "dangerous bacteria" are some of the names. Unfortunately, most news stories have only a few minutes to explain a somewhat complicated situation involving genetics, bacterial adaptation to environmental pressures, and the impact on human populations that makes the CDC researchers, scientists, and doctors concerned. This article is designed to present readers with some further insights into these "dangerous" bacteria. The CDC name for these bacteria is CRE bacteria; the CRE stands for carbapenem-resistant Enterobacteriaceae.
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