September 25, 2016
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CRE Infection (cont.)

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What causes CRE infections? How is CRE transmitted?

This resistance to carbapenem is not the only reason CRE bacteria are considered dangerous. CRE are transmitted from person to person, usually by direct contact with contaminated feces, skin, or instruments used in hospitals.

What are risk factors for a CRE infection?

  • Risk factors for CRE infection include close contact with an individual known to be infected with or colonized by CRE bacteria. Individuals who are infected with CRE are usually hospitalized.
  • Instrumentation such as endoscopy carries a risk of CRE if the instrument has not been properly sterilized.
  • Patients treated outside of the U.S. in hospitals run a higher risk for CRE.
  • Individuals who have received multiple antibiotics in the recent past, especially if they had been hospitalized, are at increased risk for developing CRE.
  • Medical caregivers who work in hospitals, especially intensive-care units, or other areas such as nursing homes, that use many different antibiotics have an increased risk of getting CRE infections or colonization.

How do CRE bacteria develop?

The genetics of Enterobacteriaceae are complex; many genera and strains possess genetic material that codes for resistance against many types of antibiotics. As a strain develops resistance to an antibiotic, not only does it become resistant to that antibiotic, the genes that confer resistance to one antibiotic become linked to each other. Consequently, as different antibiotic resistance occurs, the genetic material can become linked together thus conferring antibiotic resistance to several antibiotics in a single bacterial strain. Such bacteria that are resistant to several antibiotics are considerably more dangerous to humans they may infect than are bacteria susceptible to antibiotics.

As new antibiotics are introduced, they can pressure the bacteria to adapt to survive even the newest and most powerful ones; bacteria survive by allowing to replicate those few bacteria that develop stable resistance components that are genetically coded and then pass on genetic antibiotic resistance to other bacteria. This new genetic ability is then again linked to other antibiotic-resistant genetic material, thus resulting in "dangerous" bacterial strains that are resistant to many, if not all, antibiotics. That is the current situation for CRE bacteria. Keep in mind that there are strains of CRE bacteria that can fairly easily transfer genetic information to other bacterial strains that do not have multiple drug resistance but may have the potential to be dangerous under certain circumstances (for example, enterotoxigenic E. coli).

Medically Reviewed by a Doctor on 9/7/2016


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