CRE bacteria infection: The new health nemesis

By: Dr. Victor Marchione | immune system | Tuesday, March 17, 2015 – 9:10 a.m.


Bacteria-infection There’s something strange in the neighborhood. Who is going to call?

CRE busters!

If only it were that easy …

A new superbug that is provided to the staff in hospitals and health centers sleepless nights. It is called CRE and before telling how to prevent and fight it, I think it’s important to start with … what is CRE infection?

CRE is synonymous with carbapenem-resistant Enterobacteriaceae. These germs are difficult to treat because they have high levels of resistance to antibiotics.

How CRE was normal to dangerous

Originally, these germs are a normal part of your body healthy. But due to certain factors (which I describe below), some of these germs have become resistant to all or almost all antibiotics, including drugs of last resort called carbapenems, and hence the name of CRE. CRE infections are difficult to treat, and in some cases untreatable. In fact, CRE kills up to half of patients with bloodstream infections from them.

The fact is that we have given rise to these dangerous organisms without knowing it. Most infections occur CRE patients receiving medical care for serious problems.

In addition to spreading among people, CRE easily spread their antibiotic resistance to other types of germs, so people also potentially treatable. Therefore, it is very important that we understand in more detail. And since antibiotics helped these deadly organisms come into existence, let’s take a brief look at how antibiotics work.

Antibiotics are wonder drugs 20 th century . They are incredible because they can kill bacteria without harming humans. They do this by recognizing something very specific (target) in the cell of bacteria not found in the human cell. Once the target is isolated, antibiotic binds its target leading to the inactivation of bacteria.

The problem is that the bacteria are becoming regarding the forms of the antibiotic. In fact, we are currently in the midst of a global crisis where antibiotics are losing their effectiveness against infectious diseases.

CRE and the ineffectiveness of antibiotics
Although you read this, there are over 10,000 different types of bacteria living in or on your body. In fact, there are more bacterial cells in you that are not human cells. One of the amazing things about bacteria is their ability to share genes with each other. As you may know, you can not change your genes. If you are born with blue eyes, blue eyes. No need to change.

However, bacteria can change their genes. For example, a bacterium with a gene resistant to penicillin can collect a tetracycline resistance gene from its neighbor. It is this ability to transfer genes helped bacteria to a number of different defense tactics are developed to avoid being killed by antibiotics.

These are some of the defensive maneuvers that develop bacteria to become resistant to antibiotics earlier.

Resistance to antibiotics maneuver No. 1: Remember that I mentioned something specific antibiotic targets within bacterial cell. By the time the antibiotic enters the cell, the bacteria vomits out, preventing the pursuit of his goal. This is the technique used bacteria to become resistant to tetracycline.

Resistance to antibiotics maneuver No. 2: The bacteria change the fate enough for the antibiotic no longer recognizes. The aim is in stealth mode, the antibiotic can detect it and becomes resistant bacteria. This is the technique used to obtain bacteria resistant to streptomycin.

Resistance to antibiotics maneuver No. 3: The attack is the best defense. In this, the bacteria produce a type of weapon that go out and find the antibiotic before the antibiotic can find your target. This was the method used to overcome penicillin.

As you can see, the bacteria are constantly evolving and seeking new ways to counter the threat of antibiotics and are becoming resistant to antibiotics. And genes all these maneuvers anti-biotics are being shared by different bacteria.

Increased superbug CRE
Now his body has millions of good, innocent bacteria that cause no harm. They live in peaceful settlements within you, and stay healthy. Now imagine that some bad insects move in this neighborhood and start causing damage in the neighborhood. You start to feel sick and go to the doctor. Police deployed (antibiotics) to fight evildoers. Now the police kill the criminals, but in negotiating kill many of the good bacteria, too.

When half of the good bacteria in the neighborhood is eliminated by the antibiotic Armageddon, one of the good bacteria that was resistant to antibiotics multiplies rapidly to take the place of all the good bacteria died. So now the place of bacteria sensitive to antibiotics is absorbed by bacteria resistant to antibiotics. Thus, the antibiotic resistance gets stronger every time you take an antibiotic. The use and abuse of antibiotics has led to the genesis of CRE infections.

Symptoms of CRE
CRE can cause infections in almost any part of the body, including bloodstream infections, lung infections and infections of the digestive tract. As such, symptoms vary.

  • If there is a blood infection, symptoms are fever, chills, headache and general weakness.
  • A gastrointestinal infections (GI) infection can cause diarrhea, vomiting and abdominal pain.
  • Pulmonary infection can lead to symptoms such as coughing, difficulty breathing, blood in the sputum.

As the CRE infection can mimic other symptoms, it is important to rule out infection CRE quickly.

Transmission CRE
Similarly infections are usually associated with symptoms that vary depending on the site that is infected (for example, cough, whether in lungs, urinary symptoms, if bladder), transmission from patient to patient CRE also varies depending on the site of infection.

For example, the CRE that affects the lungs is more likely to spread faster than a CRE that affects the urinary tract. That said, if proper care is not taken care center, even the least dangerous CRE infections can be transmitted. The main risk factors include exposure to health care, especially in ICU, and exposure to antimicrobials. And even mechanical ventilation. CRE outbreaks have been associated with exposure to the centers of long-term care.

Prevention of CRE
while avoiding the CRE is more a concern of the centers of health care, there are things you can do to help prevent it. For starters, avoid indiscriminate use of antibiotics – antibiotics as it has been prescribed. Not insist on taking antibiotics for colds or flu. Antibiotics are completely ineffective against viruses, which actually accomplish nothing by taking a pill.

And if you should take antibiotics, take the whole course. If you stop taking antibiotics just because you’re feeling better soon resistant bacteria multiply, proliferate and spread to others.

Also, do not store leftover antibiotics and not medicate himself. The old antibiotic that has can not work at all against the new infection that has, so it is best to seek the advice of a doctor before attempting to treat yourself.

As CRE is endemic to health centers is important to develop a concise strategy to prevent the spread of infections CRE. The strategy should include basic measures such as:

  • Hand hygiene
    It is important that measures hand hygiene are strictly adhered to by staff and patients, and is equally important to provide feedback. Management should ensure easy access to stations hygiene
  • contact precautions
    Location CRE colonized or infected patients on contact precautions.
  • minimize the use of invasive devices
    is imperative that the instruments that may be in contact with or are used to diagnose or treat patients infected with CRE should either be completely disposable or undergo rigorous decontamination.
  • special baths The US Center for Disease Control and Prevention (CDC) recommends that patients identified with CRE infections should be bathed two percent chlorhexidine.

The long-term care for CRE
The long-term care involves a high degree of awareness of the spread of infection and ways to combat the spread. CRE place colonized or residents who are high risk for transmission over infected contact precautions.

CRE infection is just one more step in the long history of continuation of microbes and antibiotics. As you can see in the news, newer antibiotics are still being developed and released. And errors continue to evolve to find ways and means to counter the antibiotic.

And the result: Now we have to deal with superbugs as CRE. I have no doubt that we will soon find an antibiotic to completely destroy the CRE. But as you may have gathered by now, it is inevitable that the bacteria eventually become resistant to the next antibiotic.

And we, in our effort to be up on the error, to come up with the antibiotic. It’s a never ending story.

Coordinated intervention to prevent infection shown to reduce the prevalence of CRE

Society for Healthcare Epidemiology of America reported on the recent study Israel in the July 2014 its magazine Infection Control and Hospital Epidemiology (CIES):

Since 2006, Israel has faced a nationwide outbreak of CRE through its health system. A study in Israel showed that the transfer of colonized patients between acute hospitals for acute care hospitals and long-term again helped the spread of infection.

Based on these results, the Israeli government launched a multifaceted intervention in all acute care hospitals in the long term, as part of a national program.

The intervention included: 1) The site of the policies and practices of infection control assessments; 2) CRE guidelines aimed at isolation centers long-term care; 3) notifiable census carriers CRE sent to NCIC to facilitate monitoring, compliance with the guidelines and track the movements of infected patient in and out of these facilities; and 4) monitoring surveys CRE truck in patients to assess the impact of the intervention on the prevalence of the carrier.

The overall prevalence of suppliers was reduced by approximately 25 percent.

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