CRE Cases on the Rise in Southeastern US

Cases of the drug-resistant bacteria carbapenem-resistant Enterobacteriaceae increased fivefold in community hospitals in the southeastern United States from 2008 to 2012, according to a study published in Infection Control and Hospital Epidemiology.

Patients with CRE have a high risk of mortality, with at least 48 percent of cases resulting in death, according to the study. Multidrug-resistant organisms like CRE have been called "one of the…greatest threats to human health" by the World Health Organization.

The study included data from 25 community hospitals in North Carolina, South Carolina, Virginia and Georgia, members of the Duke Infection Control Outreach Network. Hospitals responded to a questionnaire and complete surveillance data from January 2008 through December 2012.

Researchers identified 305 patients with CRE, and nearly all cases were healthcare-associated: 60 percent were community-onset, healthcare-associated and 34 percent were hospital-onset, healthcare associated. Additionally, hospitals that adopted more recent and sensitive guidelines for detecting bacteria had a higher rate of CRE detection.

Several factors contributed to the higher rate of infection, according to researchers, including the following:

•    Increased use of broad-spectrum carbapenems
•    The ease with which carbapenemase enzymes can be transmitted among bacteria
•    Increased transmission between patients in healthcare settings

"This is a wake up call for community hospitals," Joshua Thaden, MD, the study's lead author, said in a news release. "More must be done to prepare and respond to CRE, specifically infection control to limit person-to-person transmission and improved laboratory detection."

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