Skip to main content

Why 'nightmare bacteria' on the rise

By Aaron E. Carroll, Special to CNN
March 8, 2013 -- Updated 0457 GMT (1257 HKT)
STORY HIGHLIGHTS
  • Aaron Carroll says rise in drug-resistant bacteria CRE should concern us all
  • He says bacterial strains -- like MSRA a few years ago -- evolve to resist antibiotics
  • Concern is over spread in hospitals now, but bug could get out into community, he says
  • Carroll: Misuse of antibiotics gives bacteria chance to evolve -- a real public health danger

Editor's note: Dr. Aaron E. Carroll is an associate professor of pediatrics at the Indiana University School of Medicine and the director of the university's Center for Health Policy and Professionalism Research. He blogs about health policy at The Incidental Economist and tweets at @aaronecarroll.

(CNN) -- The Centers for Disease Control and Prevention has sent out a warning to hospitals about a new antibiotic-resistant bacteria, carbapenem-resistant Enterobacteriaceae, or CRE. While this strain of bacteria is not new, it has become more common in the last 10 years or so and has now become prevalent enough to warrant a higher level of concern.

It's worth backing up for a second to discuss what all of this means. We use antibiotics to treat bacterial infections. When we first started developing antibiotics, such infections were easier to cure. But over time, the bacteria evolved. They developed the ability to fight the antibiotics that we use. They pass on this ability to resist treatment to bacteria that follow. Over time, we are often forced to develop new antibiotics to beat infections that were previously treated easily.

News: CDC: 'Nightmare bacteria' spreading

Aaron E. Carroll
Aaron E. Carroll

This is what has happened here with CRE. Over time, these bacteria have become harder and harder to treat. The old antibiotics don't work as well. In this case, CRE infections kill about half of patients who have bloodstream infections. This is more than twice as many people who die from similar infections with antibiotic-susceptible strains.

Right now, CRE only are of concern to certain susceptible patients in the hospital. It's not common in the community, and most of the warnings are directed at hospitals, imploring them to take precautions to isolate patients and prevent spread in the inpatient setting.

The nightmare scenario, though, is that this bacteria will get out into the community.

Become a fan of CNNOpinion
Stay up to date on the latest opinion, analysis and conversations through social media. Join us at Facebook/CNNOpinion and follow us @CNNOpinion on Twitter. We welcome your ideas and comments.



This isn't fear-mongering. Years ago, Staphylococcus aureus infections were also relatively easy to treat. Over time, though, a strain of bacteria, known as Methicillin-resistant Staphylococcus aureus, or MRSA, became a problem in hospitals. The CDC issued warnings to hospitals to take precautions to prevent its spread. Over time, though, it got out into the community.

A 2008 study of children who came into an emergency department with skin abscesses, or infections, found that about 75% of them were caused by MRSA. Luckily, we still have medications, such as trimethoprim/sulfamethoxazole, to treat these infections. When that fails, though, things will become even more concerning.

Put another way, when I was training, we would have almost never considered MRSA as the cause of a skin infection. These days, though, we pretty much assume it's the cause, and treat with stronger drugs.

Most people believe that the injudicious use of antibiotics is to blame for these developments. Every time we use antibiotics, we give bacteria a chance to evolve. We kill off those susceptible to the drugs and leave those that have developed resistance. Each time we use antibiotics unnecessarily, say to treat a virus, we make the problem worse. Each time we use them improperly, or for too short a period of time, we do the same. These days, we're putting them in everything, from soap, to lotion, to the food that animals eat.

This is a real public health issue. Creating more resistant strains is a serious long-term problem. The new warning is panicking a lot of people, but for the wrong reasons. You're very, very unlikely to get a CRE infection anytime in the near future. It's important that hospitals work to prevent that problem from getting worse, but almost everyone reading about it this week will be unaffected by it.

It's much, much more likely, though, that these same people will ask for antibiotics when they get a cold. That's the kind of thing that will lead to future problems. That's the kind of thing we need to stop now.

Follow us on Twitter @CNNOpinion.

Join us on Facebook/CNNOpinion.

The opinions expressed in this commentary are solely those of Aaron E. Carroll.

ADVERTISEMENT
Part of complete coverage on
December 22, 2014 -- Updated 2239 GMT (0639 HKT)
Conservatives know easing the trade embargo with Cuba is good for America. They should just admit it, says Fareed Zakaria.
December 20, 2014 -- Updated 0112 GMT (0912 HKT)
We're a world away from Pakistan in geography, but not in sentiment, writes Donna Brazile.
December 19, 2014 -- Updated 1709 GMT (0109 HKT)
How about a world where we have murderers but no murders? The police still chase down criminals who commit murder, we have trials and justice is handed out...but no one dies.
December 18, 2014 -- Updated 2345 GMT (0745 HKT)
The U.S. must respond to North Korea's alleged hacking of Sony, says Christian Whiton. Failing to do so will only embolden it.
December 19, 2014 -- Updated 2134 GMT (0534 HKT)
President Obama has been flexing his executive muscles lately despite Democrat's losses, writes Gloria Borger
December 18, 2014 -- Updated 1951 GMT (0351 HKT)
Jeff Yang says the film industry's surrender will have lasting implications.
December 18, 2014 -- Updated 2113 GMT (0513 HKT)
Newt Gingrich: No one should underestimate the historic importance of the collapse of American defenses in the Sony Pictures attack.
December 10, 2014 -- Updated 1255 GMT (2055 HKT)
Dean Obeidallah asks how the genuine Stephen Colbert will do, compared to "Stephen Colbert"
December 18, 2014 -- Updated 1734 GMT (0134 HKT)
Some GOP politicians want drug tests for welfare recipients; Eric Liu says bailed-out execs should get equal treatment
December 18, 2014 -- Updated 1342 GMT (2142 HKT)
Louis Perez: Obama introduced a long-absent element of lucidity into U.S. policy on Cuba.
December 16, 2014 -- Updated 1740 GMT (0140 HKT)
The slaughter of more than 130 children by the Pakistani Taliban may prove as pivotal to Pakistan's security policy as the 9/11 attacks were for the U.S., says Peter Bergen.
December 17, 2014 -- Updated 1600 GMT (0000 HKT)
The Internet is an online extension of our own neighborhoods. It's time for us to take their protection just as seriously, says Arun Vishwanath.
December 16, 2014 -- Updated 2154 GMT (0554 HKT)
Gayle Lemmon says we must speak out for the right of children to education -- and peace
December 17, 2014 -- Updated 1023 GMT (1823 HKT)
Russia's economic woes just seem to be getting worse. How will President Vladimir Putin respond? Frida Ghitis gives her take.
December 17, 2014 -- Updated 0639 GMT (1439 HKT)
Australia has generally seen itself as detached from the threat of terrorism. The hostage incident this week may change that, writes Max Barry.
December 12, 2014 -- Updated 2020 GMT (0420 HKT)
Thomas Maier says the trove of letters the Kennedy family has tried to guard from public view gives insight into the Kennedy legacy and the history of era.
December 15, 2014 -- Updated 1456 GMT (2256 HKT)
Will Congress reform the CIA? It's probably best not to expect much from Washington. This is not the 1970s, and the chances for substantive reform are not good.
December 15, 2014 -- Updated 2101 GMT (0501 HKT)
From superstorms to droughts, not a week goes by without a major disruption somewhere in the U.S. But with the right planning, natural disasters don't have to be devastating.
December 15, 2014 -- Updated 1453 GMT (2253 HKT)
Would you rather be sexy or smart? Carol Costello says she hates this dumb question.
December 14, 2014 -- Updated 2253 GMT (0653 HKT)
A story about Pope Francis allegedly saying animals can go to heaven went viral late last week. The problem is that it wasn't true. Heidi Schlumpf looks at the discussion.
December 14, 2014 -- Updated 1550 GMT (2350 HKT)
Democratic leaders should wake up to the reality that the party's path to electoral power runs through the streets, where part of the party's base has been marching for months, says Errol Louis
December 13, 2014 -- Updated 2123 GMT (0523 HKT)
David Gergen: John Brennan deserves a national salute for his efforts to put the report about the CIA in perspective
December 12, 2014 -- Updated 1426 GMT (2226 HKT)
Anwar Sanders says that in some ways, cops and protesters are on the same side
December 11, 2014 -- Updated 1439 GMT (2239 HKT)
A view by Samir Naji, a Yemeni who was accused of serving in Osama bin Laden's security detail and imprisoned for nearly 13 years without charge in Guantanamo Bay
December 14, 2014 -- Updated 1738 GMT (0138 HKT)
S.E. Cupp asks: How much reality do you really want in your escapist TV fare?
ADVERTISEMENT