Superbugs may be More Widespread than Previously Thought

The potentially deadly, drug-resistant “superbug,” carbapenem-resistant Enterobacteriaceae (CRE), is more widespread in U.S. hospitals than previously thought, an earlier-released study has found. [1]

Researchers looked for cases of infections caused by CRE in a sample of 4 U.S. hospitals – 3 in the Boston area and 1 in California – and identified numerous varieties of the bacterium. [2]

Each year, CRE bacteria sicken about 9,300 people and claim the lives of 600 people in the United States, according to the CDC. Those numbers are climbing. CRE bacteria, in particular, have been called “nightmare bacteria” by CDC Director Tom Frieden because they often continue to thrive even in the face of “last-resort” antibiotics – drugs reserved for the toughest infections. [1]

Read: It’s Here – Bacteria Resistant to ALL Antibiotics Shows up in the U.S.

In the study, the researchers also found that CRE has a plethora of genetic traits that make it resistant to antibiotics, and these traits can be easily transferred between the many CRE species.

The study documented the identical gene in different species. William Hanage, associate professor of epidemiology at Harvard Chan School and senior author of the study, says that “the extent to which this has happened is really quite surprising,” He added that the team “found 2 cases of high-level resistance we could not explain.”

He compared it to dark matter: 

“We know it’s there because we can see its effects, but what’s actually making it happen at the moment is unknown. If I were to criticize my own work, I would say it is a shame that we weren’t able to get more hospitals and more samples from elsewhere within the health care systems.”

Based on the findings, the researchers believe that CRE is more common than previously thought, and that it may be transmitted from person to person without causing symptoms.

Source: CBC News

In fact, Dr. Alex Kallen, a medical officer in the CDC’s Division of Healthcare Quality Promotion, said “the most common source of transmission with CRE is asymptomatic.” For that reason, the team writes in Proceedings of the National Academy of Sciences, there needs to be increased surveillance of CRE. [2]

A healthy person might be able to carry CRE (it resides in the gastrointestinal tract) without developing an infection. However, if the bacterium is transferred to someone with a compromised immune system, it can be deadly. [1] [2]

Hanage said:

“We often talk about the rising tide of antibiotic resistance in apocalyptic terms. But we should always remember that the people who are most at risk of these things would be at risk for any infection, because they are often among the frailer people in the health care system. [2]

While the typical focus has been on treating sick patients with CRE-related infections, our new findings suggest that CRE is spreading beyond the obvious cases of disease. We need to look harder for this unobserved transmission within our communities and health care facilities if we want to stamp it out. [1]

The best way to stop CRE making people sick is to prevent transmission in the first place. If it is right that we are missing a lot of transmission, then only focusing on cases of disease is like playing whack-a-mole; we can be sure the bacteria will pop up again somewhere else.”

On a related front, it has come to light that a Nevada woman in her 70’s died months ago from a CRE infection that none of the 26 antibiotics available in the United States would touch. Dr. James Johnson, a professor of infectious diseases at the University of Minnesota, said of the case:

“I think this is the harbinger of future badness to come.” [3]

Read: Antimicrobial Resistance Could be a “Bigger Threat Than Cancer by 2050”

Johnson added that it’s hard to believe nobody else in the country is carrying the same strain. He said that when people ask him “How close are we to the edge of the cliff?,” he tells them: “We’re already falling off the cliff.”

Last fall, a Reuters investigation revealed that thousands of U.S. deaths due to superbugs go unreported each year, because in many cases it is not indicated on death certificates.

Source:

[1] HealthDay

[2] CNN

[3] USA Today

CBC News

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About Mike Barrett:
	Mike is the co-founder, editor, and researcher behind Natural Society. Studying the work of top natural health activists, and writing special reports for top 10 alternative health websites, Mike has written hundreds of articles and pages on how to obtain optimum wellness through natural health.

Thousands of U.S. Deaths from Superbugs go Unreported

Superbugs kill tens of thousands of Americans each year, but it’s often not reflected on death certificates. This lack of transparency makes it difficult for health officials to accurately track the spread of antibiotic resistance. [1]

Take the case of Josiah Cooper-Pope, a baby born 15 weeks premature, who died from methicillin-resistant Staphylococcus aureus, or MRSA, in the neonatal unit at 17 days old. No one at Chippenham Hospital in Richmond, Virginia, told Josiah’s mother, Shala Bowser, that her son was the 4th newborn to die from MRSA. Records show 8 other babies were sickened by the superbug – nearly every baby in the unit – before the outbreak had run its course.

Yet, Josiah’s birth certificate listed the cause of death as “Sepsis due to (or as a consequence of): Prematurity.”

Sepsis is a complication of the infection, but MRSA was listed nowhere on the certificate.

Bowser said:

“My heart hurts. I saw what this did to him. And then they just threw a bunch of words on the death certificate.”

It’s not just baby deaths that are being covered up. An investigation by Reuters turned up others: Emma Grace Breaux died at age 3 from complications of the flu; Joshua Nahum died at age 27 from complications related to a skydiving accident; and Dan Greulich succumbed to cardiac arrhythmia at age 64 after a combined kidney and liver transplant.

In each case, death was caused by a drug-resistant bacterial infection contracted while the patients were in the hospital, yet none of the death certificates reflect that.

Read: Superbugs Could Kill 10 Million People by 2050

In fact, according to Reuters, thousands upon thousands of people die from drug-resistant superbugs each year, but they go uncounted because federal and state agencies do a terrible job of tracking them. The U.S. Centers for Disease Control (CDC) and state health departments lack the political, legal, and financial capacity to impose strict monitoring.

As an example, carbapenem-resistant enterobacteriaceae, or CRE, is one of the country’s most urgent health threats. For that reason, the CDC recommends that local health officials require hospitals to report cases of the infection. [2]

It was reported last year that a CRE outbreak had affected patients treated at hospitals in 42 states, including 1 in Central Pennsylvania, and 1 in the Los Angeles area.

The outbreak was linked to insufficient sterilization procedures for a certain type of medical device, called an endoscope, which led to a massive recall of the Olympus-made devices last January.

When reporting drug-resistant bugs isn’t possible, agency guidelines suggest that health departments still survey hospitals and nursing homes for the presence of the superbug to ensure facilities are trying to halt its spread.

But these are merely recommendations.

How Can We Beat a Problem We Don’t Report On?

How do you fight such a grave, looming threat if you don’t know the full scope of the problem?

Director of the Center for Disease Dynamics, Economics & Policy, a Washington-based health policy research organization, Ramanan Laxminarayan said:

“You need to know how many people are dying of a disease. For better or worse, that’s an indicator of how serious it is.”

CDC officials warned in October that they’d discovered that some hospitals had attempted to keep their infection-control staff from reporting certain types of hospital-acquired infections to a national database as required.

A survey published in a CDC medical journal in 2010 showed that 49% of New York City medical residents said they had willfully reported an inaccurate cause of death on a certificate.

Why Cover up Superbug Deaths?

There are a number of reasons why drug-resistant infections are not acknowledged on birth certificates. [1]

• Insufficient Training. Doctors and other healthcare workers often receive insufficient training on how to fill out the proper forms.

• Impatience. Some doctors just want to fill out the forms and be done with it, and opt out of waiting the several days it can take for a laboratory to confirm an infection.

• Fear of a Damaged Reputation. Counting deaths is tantamount to documenting your own failures, Reuters points out. Acknowledging these failures puts hospitals and medical professionals at risk of potential malpractice lawsuits, loss of insurance reimbursements, and public-relations nightmares.

And in most states, there is no law requiring that drug-resistant infections be listed as a cause of death. The only exceptions are Washington and Illinois.

Most states use a model law that mandates financial penalties for anyone who deliberately makes a false statement on the document, but those penalties are often negligible and rarely enforced.

Better Surveillance and Accountability

Source: MicroBEnet

Ed Winter, assistant chief in Los Angeles County’s medical examiner-coroner’s office, said that any time a patient dies from a suspected hospital-acquired infection, the individual should be sent to the medical examiner for review to determine whether county officials, rather than hospital doctors, should determine the cause of death. [2]

Winter said:

“If there is a question, we will look into it.”

Read: World Leaders Meet to Finally Address Antibiotic Resistance Crisis

Additionally, Johns Hopkins Hospital surgeon Dr. Martin Makary urged the CDC in May to add a line to all death certificates where doctors would be asked if the death was the result of a preventable complication from medical care (such as CRE caused by improper sterilization).

He estimates that infections, errors, and other cases of “medical care going wrong” would be at least the third-leading cause of death among Americans if they were properly recorded.

“We need an open and honest conversation about the problem.”

Sources:

[1] Reuters

[2] Los Angeles Times

MicroBEnet

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About Julie Fidler:
	Julie Fidler is a freelance writer, legal blogger, and the author of Adventures in Holy Matrimony: For Better or the Absolute Worst. She lives in Pennsylvania with her husband and two ridiculously spoiled cats. She occasionally pontificates on her blog.