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New ‘Nightmare Bacteria’ Are Trying To Spread In The U.S., CDC says

What’s worse than “nightmare” bacteria that are resistant to nearly all antibiotics? New nightmare bacteria that have the potential to spread their resistance genes to germs in hospitals around the country.

“Superbug” bacteria that are resistant to antibiotics have the potential to create a nightmare scenario for modern medicine, but experts are hopeful that doctors will be able to slow the spread of these scary infections, by both traditional means and new innovations.

This image depicts two mustard-colored, rod-shaped carbapenem-resistant Klebsiella pneumoniae (CRKP) bacteria interacting with a green-colored, human white blood cells. Credit: National Institute of Allergy and Infectious Diseases (NIAID)

“Nightmare bacteria” with the power to resist most antibiotics are popping up across the U.S., but new, aggressive policies can help stop them from spreading, federal health officials said Tuesday.

A new program for testing suspect bacteria turned up unusual antibiotic-resistance genes 221 times in 2017, the Centers for Disease Control and Prevention reported. And 11 percent of people screened for these superbugs carried them, even though they had no symptoms, the CDC said.

Researchers say that last year, they identified more than 200 cases of these “nightmare” bacteria with new or rare antibiotic-resistance genes, according to a new report from the Centers for Disease Control and Prevention (CDC). These rare types of antibiotic-resistant bacteria popped up all over the country, in 27 states.

The good news is that researchers have come up with an aggressive strategy to identify, track and contain these germs, which appears to help stop their spread, according to the report.

“We are working to get in front of them before they do become common,” Dr. Anne Schuchat, principal deputy director of the CDC, said at a news conference today (April 3). “We have data showing an aggressive approach works” to halt the spread of these new threats, Schuchat said.

Nightmare bacteria

Antibiotic-resistant bacteria are, unfortunately, a common problem in medicine today — more than 2 million Americans get an antibiotic-resistant infection each year, and 23,000 die from these infections, according to the CDC. Antibiotic-resistant infections are a major concern for health care workers because they are difficult to treat.

One particularly concerning type of antibiotic-resistant bacteria is called carbapenem-resistant Enterobacteriaceae, or CRE, which has been dubbed “nightmare” bacteria. These bacteria are not only resistant to many antibiotics but are also highly lethal, killing up to 50 percent of infected patients, according to the CDC.

CRE infections first appeared in the United States only in 2001, and have increased in recent years. A CDC study found that in 2012, nearly 5 percent of U.S. hospitals, and 18 percent of long-term care facilities reported having at least one patient with CRE.

Doctors liken the spread of CRE and other antibiotic-resistant germs to a wildfire, which is difficult to contain once it spreads widely. Therefore, doctors are trying to stamp out new or unusual types of antibiotic resistance when they first appear — to extinguish the “spark” before it has a chance to grow and spread, Schuchat said.

To aid in these efforts, the CDC recently established the Antibiotic Resistance Laboratory Network (ARLN), a network of labs across the country that test patients’ samples for highly resistant bacteria and track emerging antibiotic resistance.

In the first nine months of 2017, ARLN tested more than 5,700 samples of highly resistant bacteria, including CRE, from hospitals, nursing homes and other health care facilities around the country. Of the 1,400 CRE-positive samples tested, 221 samples (15 percent) had new or unusual types of antibiotic resistance, the report said.

“I was surprised by the numbers” of bacteria with unusual antibiotic resistance, Schuchat said. “This was more than I was expecting.”

When researchers detected a case of unusual antibiotic resistance, they screened other patients in the facility to see if some had “silent” infections, meaning they were infected but weren’t showing symptoms. They found that about 1 in 10 people screened had a silent infection, meaning that “unusual resistance may have spread and could have continued spreading if left undetected,” Schuchat said.

Preventing infections

One important step to reducing CRE infections is to limit the use of powerful antibiotics to when they’re really needed, Goodman said. Studies have found that all too often, patients are given antibiotics when they don’t need them (such as when they have a cold or other infection caused by a virus), or are kept on antibiotics for too long.

For bacteria, it is costly to carry around genes for resistance against certain antibiotics unless this defense is really needed, Goodman said. So “if you can reduce people’s exposures [to antibiotics], where they’re unnecessary, you can at least slow this down,” Goodman said.

Adalja agreed, and said that alternatives to antibiotics are also needed, because in an “arms race with bacteria, there’s no question that we will lose.”

One important area of research that could help prevent antibiotic-resistant infections is the study of the microbiome, or the diverse community of microorganisms that naturally live on and in people’s bodies and promote health, Goodman said. Studies have shown that when a person’s normal gut bacteria community is disturbed, it puts that individual at risk for becoming sick with “bad” bacteria, including CRE. Research that looks into how to prevent the normal microbiome from being disturbed, or how to restore the normal microbiome after illness or antibiotics, could help treat or prevent infections, Goodman said.

New vaccines against bacterial diseases could also help protect people against certain infections that often develop in health care settings, Goodman said.

And traditional practices to prevent infections — such as consistent hand washing, and the proper use of personal protective equipment — are essential. Studies have found that hospitals can dramatically reduce CRE infections when they implement proper use of these practices, Goodman said

“I definitely think that it’s achievable to slow the spread of these infections,” Goodman said. Increasing antibiotic resistance “is a nightmare scenario, but there’s a lot we can do.”

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