One
of the biggest threats comes from carbapenemases, molecules that can make
microbes impervious to carbapenems, which are some of the most potent
antibiotics. The Enterobacteriaceae family of bacteria is the one that causes
the most infections in hospitals, and that family began to pick up resistance
to carbapenems. In 1988 these microbes, called CRE for carbapenem-resistant
Enterobacteriaceae, were first identified. Plasmids spread carbapenem
resistance, and efficiently enough that by 2001, the carbapenem-resistant
bacteria were becoming impervious to other antibiotics as well. It became
evident that more aggressive strategies were needed.
The
Centers for Disease Control and Prevention (CDC) issued directives in 2009 to
confront the problem, and there were updates in 2013 and 2015. Now the CDC
wanted to survey the state of antibiotic resistance in the United States. Data
from 2006 to 2015 from the National Healthcare Safety Network showed that there
was a decline in the number of CRE infections in hospitals.
The report
concludes:
“The proportion of Enterobacteriaceae infections that were CRE remained lower
and decreased more over time than the proportion that were ESBL phenotype. This
difference might be explained by the more directed control efforts implemented
to slow transmission of CRE than those applied for ESBL-producing strains.
Increased detection and aggressive early response to emerging antibiotic
resistance threats have the potential to slow further spread.”
See: Morbidity and
Mortality Weekly Report (MMWR) “Vital Signs: Containment of Novel
Multidrug-Resistant Organisms and Resistance Mechanisms — United States,
2006–2017.”
Posted by Dr. Tim Sandle