Resistant Bacteria: Infection Control Challenges
- A concerning surge in infections caused by bacteria resistant to nearly all antibiotics is prompting urgent warnings from public health officials.
- The Centers for disease Control and Prevention (CDC) has reported a significant increase in infections caused by Enterobacterales bacteria that produce New Delhi metallo-beta-lactamase 9 (NDM-9).
- Carbapenem-resistant Enterobacterales (CRE) were already a serious concern, but the emergence of NDM-9 further complicates treatment.
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Rising Threat: Carbapenem-Resistant Infections and teh Spread of NDM
Table of Contents
A concerning surge in infections caused by bacteria resistant to nearly all antibiotics is prompting urgent warnings from public health officials. This article details the growing crisis, its implications, and what steps are being taken to address it.
What is Happening? The Surge in NDM-Producing Carbapenem-Resistant Enterobacterales
The Centers for disease Control and Prevention (CDC) has reported a significant increase in infections caused by Enterobacterales bacteria that produce New Delhi metallo-beta-lactamase 9 (NDM-9). These bacteria are exceptionally risky because they are resistant to carbapenems, a class of antibiotics often considered a last resort for severe infections.
Carbapenem-resistant Enterobacterales (CRE) were already a serious concern, but the emergence of NDM-9 further complicates treatment. NDM-9 confers resistance to a broad spectrum of antibiotics,leaving few effective options for clinicians.
Understanding the Threat: What are CRE and NDM?
Enterobacterales are a family of bacteria commonly found in the gut. While often harmless, they can cause serious infections – including pneumonia, bloodstream infections, and urinary tract infections – particularly in individuals with weakened immune systems or underlying health conditions.
Carbapenems are powerful antibiotics that are typically reserved for infections that are resistant to other drugs.However, CRE have developed mechanisms to evade the effects of carbapenems, rendering these drugs ineffective.
NDM-9 is an enzyme produced by some CRE bacteria. This enzyme breaks down carbapenem antibiotics, making the bacteria resistant. The gene encoding NDM-9 can spread between different bacteria, accelerating the development of antibiotic resistance.
Who is at Risk? Identifying Vulnerable Populations
While anyone can contract a CRE infection, certain individuals are at higher risk:
- Hospitalized patients: Prolonged hospital stays and exposure to medical devices increase the risk of infection.
- Residents of long-term care facilities: Similar to hospitalized patients, residents are often more vulnerable due to underlying health conditions and close proximity to others.
- Individuals with weakened immune systems: People undergoing chemotherapy,organ transplantation,or living with HIV/AIDS are more susceptible.
- Individuals who have recently used antibiotics: Antibiotic use can disrupt the natural balance of bacteria in the gut, allowing CRE to flourish.
- Those who have traveled to regions with high CRE prevalence: Travel can expose individuals to CRE strains not commonly found in the United States.
Timeline of the Crisis: From Emergence to Current Surge
| Year | Event |
|---|---|
| 2009 | First reported case of NDM-1 (a related enzyme) in Sweden, originating from a patient who had received medical care in India. |
| 2010
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