CRE infections are blamed on 9,000 infections and 600 deaths a year in the United States. Up to 50% of infections are fatal because the bacteria can resist treatment with virtually every antibiotic.
UPDATE: New “Superbug” Infections Reported in Virginia Mason Outbreak
May 6, 2015 — Another seven “superbug” infections have been linked to a deadly outbreak at Virginia Mason Medical Center in Seattle, Washington, bringing the total number to 39. Fortunately, the outbreak appears to be over. Click here to read more.
April 22, 2015 — Olympus Corp. warned hospitals in Europe about the risk of transmitting “superbug” infections on contaminated duodenoscopes in January 2013, but failed to warn hospitals in the United States. Click here to read more.
March 31, 2015 — The White House and state lawmakers are demanding action to curb the emergence of CRE and other “superbug” bacterial infection outbreaks. Click here to read more.
March 26, 2015 — Olympus Corp. has issued an urgent update on how to clean the duodenoscope that has recently been linked to deadly CRE infections. Click here to read more.
March 23, 2015 — A woman from Washington who was infected with a drug-resistant infection has filed a lawsuit against Olympus, the manufacturer of a duodenoscope that transmitted the infection during her ERCP. Click here to read more.
March 9, 2015 — Hospitals do not have to inform patients when they are exposed to CRE on dirty medical scopes, which may explain why it took years for some recent outbreaks to come to light. Click here to read more.
March 5, 2015 — At least 67 patients were exposed and 4 developed antibiotic-resistant CRE infections after undergoing medical procedures involving an Olympus duodenoscope at Cedars-Sinai Medical Center in Los Angeles. Click here to read more.
March 4, 2015 — CNN reports that the duodenoscope implicated in a massive outbreak of “superbug” infections was sold without approval from the FDA. Click here to read more.
March 3, 2015 — Olympus Corp. has been hit with a wrongful death lawsuit by the family of a woman who developed a CRE infection after undergoing a procedure with a duodenoscope that was not sterilized. Click here to read more.
February 23, 2015 — A hospital in North Carolina has reported that three people have been infected and one person has died from CRE infections. Click here to read more.
CRE Infection Outbreak at UCLA Hospital
February 2015 — An outbreak of CRE at UCLA’s Ronald Reagan Medical Center has caused two deaths, seven infections, and exposed 179 people.
All of the patients were treated with a duodenoscope, which is a type of endoscope that is inserted down a patient’s throat. The scope is used during a procedure known as ERCP, which is often used to treat gallstones and cancer.
The FDA has warned that the complex design of the scope is nearly impossible to sterilize effectively. At least one victim is filing a lawsuit against the scope manufacturer.
According to the Los Angeles Times:
“These outbreaks are raising questions about whether hospitals, medical-device companies and regulators are doing enough to protect patient safety. Some consumer advocates are also calling for greater disclosure to patients of the increased risks for infection before undergoing these procedures.”
What is a CRE Infection?
Carbapenem-resistant Enterobacteriaceae (CRE) is a family of antibiotic-resistant bacteria.
They have evolved to create an enzyme that inactivates antibiotics, making infections nearly impossible to treat. The enzyme is a new adaptation that was first discovered in 2001.
CRE is resistant to almost all antibiotics, including carbapenems, which are a last-resort treatment when other antibiotics fail. The remaining treatments are often extremely toxic to the patient. An estimated 40-50% of CRE infections are deadly.
CRE Infection Transmission
CRE is mostly transmitted in hospitals or long-term care facilities. It can spread by touching an infected wound, forgetting to wash your hands after touching feces, or on a contaminated medical devices like an endoscope.
Healthy people often carry CRE in their digestive tract without any problem. But when CRE is transmitted to people who are on antibiotics (which clear out good and bad gut bacteria) or in poor health, CRE can rapidly spread outside the intestines and cause nearly-untreatable bloodstream infections.
Risk-Factors
- Patients who are treated with an endoscope or duodenoscope (long, flexible tube inserted into the mouth or rectum to treat diseases of the digestive tract, pancreas, bile duct, cancer, or gallstones)
- Patients whose care requires devices like ventilators (breathing machines), urinary (bladder) catheters, or intravenous (vein) catheters
- Patients who are taking long courses of certain antibiotics
CRE infection Symptoms
The symptoms of a CRE infection depend on the disease the bacteria has caused — pneumonia, urinary tract infections, bloodstream, and wound infections are all possible.
General symptoms of an infection include:
- Fever
- Diarrhea
- Inflammation
- Muscle aches or cramping
- Fatigue
- Coughing and sneezing
- And more
CRE Colonization vs. Infection
Some people may not require treatment if they are “colonized” with CRE rather than infected. Colonization means that CRE can be found on the body, but it is not causing any problems. However, CRE can cause infections if they gain access to the bladder, lungs, or bloodstream. Transmission often occurs on a catheter, ventilator, or endoscope.
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