What to Know About the CRE 'Superbug' Infecting UCLA Patients

179 people at a California hospital exposed to antibiotic-resistant bacteria.

ByABC News
February 19, 2015, 11:29 AM

— -- intro:Seven patients at a California hospital have been infected with a drug-resistant "superbug" and 179 people were exposed to it, according to health officials. But with several so-called superbugs out there, the health scare can be confusing.

Here's what you should know about Carbapenem-resistant enterobacteriaceae, or CRE, the bug that's affecting patients at Ronald Reagan UCLA Medical Center.

quicklist:1category: title: What is CRE?url:text:CRE is family of germs normally found in the gut that have become resistant to a class of antibiotics that includes penicillin, amoxicillin and several other commonly used drugs that help fight harmful bacteria. These germs have an extra enzyme that breaks up antibiotics, making them difficult to treat, according to the U.S. Centers for Disease Control and Prevention.

quicklist:2category: title: How serious is it?url:text:"It really depends on the patient, not the bug sometimes," said Dr. Frank Esper, an infectious diseases expert at UH Case Medical Center in Cleveland, Ohio.

If CRE is in a healthy gut, it won't necessarily cause an infection, Esper said. But if it gets into the blood, the bladder, or a wound on the skin, it can cause serious illness and death. And if someone has an underlying medical condition like cancer or pancreatitis, the patient is more likely to come down with a serious infection.

About half of the people who develop CRE in a hospital will die, according to the CDC, but it's important to note that these patients are already very sick. As a result, it's hard to say whether CRE caused or played a role in their deaths.

According to Ronald Reagan UCLA Medical Center, CRE may have played a role in two of its patients' deaths.

quicklist:3category: title: How is it spread?url:text:CRE is considered a hospital-acquired infection because it normally spreads on contaminated intravenous lines, catheters and other devices.

At Ronald Reagan UCLA Medical Center, a contaminated endoscope was to blame, the hospital said.

An endoscope is a long tube with a camera on the end that's used to help doctors take a look at the inside of the digestive tract. And while endoscopy helps doctors catch diseases they would otherwise never be able to see, endoscopes are to blame in more hospital-acquired outbreaks than any other device because they're exposed to so many colonies of bacteria, Esper said.

quicklist:4category: title: How is it treated?url:text:Since CRE is resistant to most antibiotics, doctors are forced to use the antibiotics they stopped using 40 or 50 years ago, Esper said. The germs "forgot" how to be resistant to these older antibiotics, but doctors stopped using them because they were more toxic, he said.

"We don't have a lot of choices," he said. "There are not a lot of drugs coming out of the antibiotic pipeline."

He said drug companies have stopped making new antibiotics because there isn't as much money in making something a patient doesn't have to take long term, but doctors have been begging for new antibiotics for decades.

quicklist:5category: title: Has a CRE outbreak ever happened before?url:text:Yes. According to the CDC, almost every state has had a confirmed case of CRE, but state health departments are not required to notify the CDC about CRE infections.

Last month, a report revealed that a Seattle hospital had a CRE outbreak in which 23 patients were exposed between 2012 and 2014. Eleven people died, but it's hard to say whether the superbug played a role in their deaths. Similar incidents have occurred in Pittsburgh and Chicago.

quicklist:5category: title: How is CRE different from other superbugs?url:text:Most superbugs are drug-resistant bacteria.

One that's probably familiar is MRSA, or methicillin-resistant Staphylococcus aureus, which is a bacteria normally found in the nose that can infect sick patients via contaminated intravenouses, for instance. But there are more treatments for MRSA because it isn't resistant to as many antibiotics as CRE.

Read about other superbugs here.