Henry has enough problems without donated bugs from the community. But back he goes–for the second time in a week–to the hospital to be treated for pneumonia. He is off oxygen, I just learned, and may go home today.
And I’m was worried about the risk of his entering the hospital as I am about the condition that sent him there. Hospitals–and extended-care facilities–are increasingly becoming the place to go to pick up strange, new and terrible genetic mash-up organisms that cannot be killed.
My wife enters this kind of environment daily in her work. So we do keep an eye on the nosocomial super-bugs. And a new one is on the loose.
You probably know about MRSA. It “appeared” while I was in the health care field, and required “suiting up” to visit and work with an increasing number of hospital patients who needed physical therapy.
The M in MRSA is for methicyllin (changed recently to meticillin.) It’s a version of penicillin. It used to work against staph infections until the bacteria “acquired” the genetic ability to resist the drug.
Bacteria are amazing creatures. The term “species” that indicated genetic isolation and uniqueness don’t mean so much when it comes to bacteria. The lines are not nearly so clear what makes a “species” because genetic bits called “plasmids” can be readily exchanged across what we might think of as species boundaries.
And that’s bad news, because the genetic bit that contains antibiotic resistance is moving like wildfire. And when a common bacteria–like E. coli–picks up such a weapon against the most effective treatment, it means serious challenge to recover if it finds your tissues to live in.
CRE stands for Carbapenem Resistent Enterobacteria.
Carbapenem is a fairly new class of antibiotics whose strong suit has been its broad spectrum coverage and its strong stand against resistant bacteria. Until recently.
CRE’s rapid rise in hospitals and extended care facilities, plus its 50% lethality, lead to its possible future evolution being referred to as a “nightmare scenario” and even wikipedia saying that “worldwide spread of the resistance gene is considered a potential nightmare scenario.”
So far, it seems to be found in places where infection control measures can keep it in check. It could do what MRSA has done.
Now, there is “Community-acquired MRSA.”
Be very concerned when CRE leaves the building.
This piece from NPR is a good starting place if you’re interested in learning how to reduce the spread of CRE and MRSA for your hospitalized relatives and friends.