02/19/2015 09:32 am ET Updated Feb 19, 2015

What Are The 'Superbugs' Known As Carbapenem-Resistant Enterobacteriaceae?


Seven patients are infected and almost 200 others were exposed to a potentially fatal group of "superbugs" carbapenem-resistant Enterobacteriaceae, or CRE, at Ronald Reagan UCLA Medical Center. The bug may have played a role in the deaths of two patients.

UCLA said in a statement Wednesday that the exposure may have occurred during endoscopic procedures.

Carbapenem-resistant Enterobacteriaceae is a class of germs that is highly resistant to treatment with antibiotics, according to the Centers for Disease Control and Prevention. Some Enterobacteriaceae are actually a normal part of human gut bacteria, like Klebsiella and E. coli, but experts say the overuse and misuse of antibiotics has been causing some bacteria to become resistant to modern medicine.

Infections with CRE are very difficult to treat and can be deadly. Because CRE is a group of germs, different kinds lead to different illnesses, including pneumonia, urinary tract infections and bloodstream infections, according to the CDC.

However, healthy people don't usually contract CRE infections, according to the CDC, since "superbugs" typically affect patients in health care settings, who are usually being treated for a different condition. People with compromised immune systems may have an increased risk.

For a person to be infected, CRE germs must enter the body, typically through contact with an infected person's wounds or feces. However, as is suspected in the UCLA exposure, the bacteria can also be passed via medical devices that enter the body. The same type of medical device has been implicated in other CRE exposures, according to UCLA. The hospital says it is now "utilizing a decontamination process that goes above and beyond manufacturer and national standards."

Some people exposed to CRE will not become infected and are said to be colonized with CRE. They won't need treatment. Certain antibiotics may offer relief for those infected with drug-resistant bacteria, but further research is still needed to identify the most effective treatment measures.

Alarmingly, hospital CRE exposures are far from unheard of. In fact, reports suggest "superbug" infections are on the rise, although still highly uncommon. As of February 2014, the CDC had confirmed CRE cases in all but three states. About 4 percent of U.S. hospitals saw at least one CRE infection in the first half of 2012, The Associated Press reported. And researchers reported that from 2008 to 2012, the amount of CRE detected in community hospitals in the southeastern part of the country increased fivefold.

"We're trying to sound the alarm. This is a problem for all of us in health care," Deverick J. Anderson, senior author of the study and an associate professor of medicine at Duke, told USA Today. "These [bacteria] are just about as bad as it gets."

Currently, the best measures to take are preventive. Hospitals and patients alike should practice careful hand-washing and disinfecting of hospital rooms and medical equipment, and staff may consider keeping patients with CRE infections from sharing rooms with others. The CDC also urges patients and medical professionals to avoid unnecessary prescriptions and use of antibiotics.



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