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home : features : vitality October 03, 2015

1/12/2014 6:00:00 AM
CRE: New antibiotic-resistant organisms
Yavapai Regional Medical Center

Since World War II, when penicillin was first used to treat infections in troops, antibiotics have become an important, even integral part of our modern lives. Billions of pounds of antibiotics are made and used around the world each year, with about half devoted to treating human illness and most of the remainder used in agriculture, often as additives to animal feed.

Antibiotics have saved many lives over the last 70 years. However, over time, bacteria and other organisms have adapted ways to survive antibiotic treatment. Those germs that survive develop something called "antibiotic resistance" and can no longer be killed by drugs that may have previously been effective. In fact, by some estimates, resistance can develop within two years or less after the introduction of a new antibiotic or antimicrobial medication.

"Superbugs," the bacteria and other organisms that manage to develop resistance to more than one medication, present a serious and sometimes deadly challenge to public health and have become one of the most urgent healthcare concerns of the 21st century, according to the Centers for Disease Control and Prevention (CDC).

CRE, which stands for carbapenam-resistant enterobacteriaceae, is a group of bacteria that have developed resistance to carbapenem antibiotics, a relatively new class of medications used to treat severe infections. CRE are some of the newest multiple-drug-resistant superbugs under intensive study by the CDC. These organisms can spread rapidly and are immune to most antibiotic treatments. Patients who require lengthy stays in healthcare facilities are at risk for developing CRE infections. Also, at risk are those taking long courses of antibiotics and individuals whose care requires the use of devices like ventilators, urinary catheters or intravenous (IV) catheters.

Fortunately, there are things that patients, healthcare providers, public health organizations and industry can do to prevent CRE infections. Using antibiotics responsibly in healthcare and at home is the first step in the campaign to stop the spread of these and other superbugs. Sue Boggler, MSN, RN, CIC, with the Infection Prevention Department at Yavapai Regional Medical Center (YRMC), states "YRMC is actively engaged in sound antibiotic stewardship and both Infection Prevention and the YRMC pharmacists work with physicians to ensure responsible antibiotic use." Boggler adds, "The public can do their part by learning to avoid antibiotic treatment for things such as the common cold or flu and to be sure to take the full course of antibiotic therapy when it is prescribed."

The CDC has developed strict guidelines to prevent infection and the spread of superbugs in healthcare facilities. Proper hand hygiene, patient handling techniques, patient isolation, appropriate and conservative use of medical devices like ventilators and catheters, and continuing public and professional education are considered essential components of the prevention plan.

In agriculture, antibiotics are often used in small, sub-therapeutic doses to promote the growth of animals destined for human consumption. Growing evidence indicates that the sub-therapeutic use of antibiotics in animal husbandry contributes to the emergence of deadly superbugs. The CDC and other organizations are working with the agricultural industry to decrease the use of antibiotics for anything other than treating disease.

The CDC is also encouraging pharmaceutical companies to create new classes of antibiotics to fight the spread of superbugs. However, developing new, more powerful medications takes considerable time and expense, and disease-causing organisms can potentially develop resistance to any drug. Therefore, prevention is extremely important in the battle against multiple-drug-resistant bacteria. The CDC has more information available on CRE and other superbugs on their website at

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