Outbreak of Drug-Resistant Bacteria “CRE” Involves Patients at Lutheran General Hospital

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Among 44 cases of a strain of bacteria called carbapenem-resistant enterobacteriaceae, or CRE, in northeast Illinois, 38 confirmed cases involved patients at Advocate Lutheran General Hospital in Park Ridge who had an endoscopic procedure of the pancreas or bile ducts between January and September 2013.

Only 69 cases have been reported in the United States since the bacteria was first reported in 2009.

The largest previous outbreak involved 10 cases in Denver, Colorado.

Carbapenems are a class of β-lactam antibiotics with a broad spectrum of antibacterial activity. They have a structure that renders them highly resistant to most β-lactamases.

The most common infection the CRE bacteria causes is a urinary tract infection, but if that infection goes to the bloodstream and develops into septicemia, the patient has a 40 to 50 percent chance of dying. There are currently no new antibiotics in development to combat bacteria resistant to carbapenems, and worldwide spread of the resistance gene is considered a potential nightmare scenario.

CRE is in a family of more than 70 bacteria including E. coli that normally live in the digestive system, according to the Illinois Department of Public Health. Some members of the group – particularly Escherichia coli and Klebsiella pneumoniae – are important causes of infections contracted by the sick patients in a hospital.

A history of undergoing the pancreas procedure endoscopic retrograde cholangiopancreatography (ERCP) was strongly associated with the bacteria, according to the CDC’s Morbidity and Mortality Weekly Report issued Jan. 3, 2014.

Most of the patients that were screened at Lutheran General Hospital had the colonized form of CRE bacteria; they weren’t infected by the bacteria.

See also …

Centers for Disease Control and Prevention (CDC).Notes from the Field: New Delhi Metallo-β-Lactamase-Producing Escherichia coli Associated with Endoscopic Retrograde Cholangiopancreatography – Illinois, 2013. MMWR Morb Mortal Wkly Rep. 2014 Jan 3;62(51):1051.

Pennington, Hugh (2010-08-11). “Can we stop the Indian superbug?“. The Daily Telegraph (London).

Medical School – Antibiotics: Carbapenems.

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