Foreign Superbugs Invade The U.S

Two new cases of what is being deemed an emerging “superbug” have been confirmed by the Centers for Disease Control and Prevention. Both cases occurred in my home state of Rhode Island, and bring light to an emerging threat that people need to be made more aware of.

This new threat, known as carbapenem-resistant Enterobacteriaceae (CRE), describes a family of germs that are highly resistant to many antibiotic treatments. CRE can be found in the normal gut flora of humans, where such bacteria can survive without causing any clinical problems in healthy individuals. For those with compromised immune systems however, CRE can wreak havoc through mechanisms of destruction similar to that of C. diff and other opportunistic pathogens.

What is important to mention about this new threat is that it involves the presence of an enzyme that has been found in several types of gram-negative bacteria. This enzyme, known as New Delhi metallo-beta-lactamase (NDM), aids in the survival of the bacteria in which it is found, as a new line of defense in the resistance to antibiotics. For example, the two cases reported in Rhode Island involved E. coli and Klebsiella pneumoniae, which both contained the NDM enzyme.

The first case involving the enzyme in the United States was reported by the CDC in 2010.  In Europe, the presence of this enzyme had been causing alarm for at least two years before occurring in the United States. The important fact here is that this new threat did not arise in the United States, but was rather brought over from other countries. In the first Rhode Island case, the CDC explained that they believe the woman who tested positive for CRE containing the NDM enzyme had just returned home from a trip back to her native Cambodia, where she had been hospitalized during her stay.

While these two new cases bring the number of NDM cases in the United States to a total of 13, they also highlight the fact that hospitals in the United States are being forced to deal with highly resistant strains of bacteria that they have never seen before.

In a previous post, I discussed the release of a new drug to treat C. diff. While such advancements are great, we must be sure to use them wisely. The emergence of this new superbug simply reinforces this. These disease-causing bacteria are striving to survive just as any other organism does. Therefore, they have the ability to evolve and adapt in order to ensure their survival.

I often try to reinforce the idea of cooperation among patients and healthcare professionals when talking about what can be done to improve patient safety and to reduce the risk of medical error. Working together can also aid in the fight against antibiotic resistance. Doctors need to be sure to prescribe antibiotics only when necessary, and patients need to take such treatments specifically as they were prescribed. The overuse and misuse of antibiotics are two of the main contributing factors to antibiotic resistance.

Hand-hygiene and disinfectant practices aimed at the prevention of healthcare-associated infections are also essential in fighting these superbugs. We need to focus on preventing such diseases before they spread, thus taking away the need for treatment.

Every time a patient in the hospital contracts one of these superbugs, treatment involves exposing the bacterial organisms to the strongest of antibiotic treatments, creating more opportunity for such bacteria to evolve and adapt. Just think about how many individuals you have heard of that have been affected by MRSA when they weren’t even sick. By abusing antibiotics and allowing germs to spread, we’re creating more and more potential threats for the human race. Once again, we have the opportunity to make changes that will save lives in the present and also help future generations. It all starts with getting the general public aware of the issue while they are still able to help themselves.

Image via: Creative Commons

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