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CRE Superbug: What It Is, Who's Vulnerable, And Why Antibiotics Can Be A Problem


Hospitals in the Charlotte region are taking extra precautions against a deadly superbug called CRE. That's after a recent outbreak at a UCLA hospital. The infection is difficult to treat, but it's extremely rare for healthy people to get it inside or outside of hospitals.

What exactly is CRE?

It's a kind of bacteria that can be harmless in your gut, but can cause serious infections in your bloodstream or elsewhere. This is not an airborne kind of thing – CRE spreads through contact, especially with wounds or feces.

It can also spread through medical devices. That's what happened at the UCLA hospital. A particular kind of scope used for a particular kind of endoscopy wasn't adequately sterilized. The FDA later said the way it's designed makes it tougher to clean. 

Do Charlotte hospitals use that same kind of scope?

They do, but it's only a problem if CRE germs get on one of those scopes and then it's used on other people. Novant Health and Carolinas HealthCare System say they've been cleaning their scopes even more thoroughly than usual to make sure that doesn't happen.

Have they had cases of CRE?

Yes, although the numbers are tiny. In the past year at Novant hospitals in the Charlotte area, for example, seven people had CRE infections. But for those few who do get it, it can be lethal. Dr. Sid Fletcher of Novant said three of the seven died.

"I should mention that they had many things going on and it's difficult to determine what the actual cause of death was," Dr. Fletcher said.

That brings up another key point: most of the time, CRE only infects the sickest patients, who can be battling a host of things in a hospital or nursing home.

Is that why it's so tough to treat?

That, and antibiotics basically don't work against it. This is actually a growing problem in health care because of how much we use antibiotics. Dr. Arjun Srinivasan is with the Centers for Disease Control and Prevention. Here's his explanation:

"When you expose bacteria to antibiotics, over time, the bacteria become resistant to those antibiotics," he said. "That is an inevitable part of evolution - it's going to happen. But the more we expose bacteria to antibiotics, the faster that resistance then develops."

So one way that hospitals are fighting CRE is by adjusting how they treat all of their patients: Novant and others have started using antibiotic stewardship programs to make sure they're not overprescribing them.