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
September 1, 2014 -- Updated 1221 GMT (2021 HKT)
Carlos Moreno says atheists, a sizable fraction of Americans, deserve representation in Congress.
August 31, 2014 -- Updated 1625 GMT (0025 HKT)
Julian Zelizer says Democrats and unions have a long history of mutual support that's on the decline. But in a time of income inequality they need each other more than ever
August 31, 2014 -- Updated 0423 GMT (1223 HKT)
William McRaven
Peter Bergen says Admiral William McRaven leaves the military with a legacy of strategic thinking about special operations
August 29, 2014 -- Updated 1611 GMT (0011 HKT)
Leon Aron says the U.S. and Europe can help get Russia out of Ukraine by helping Ukraine win its just war, sharing defense technologies and intelligence
August 29, 2014 -- Updated 1724 GMT (0124 HKT)
Timothy Stanley the report on widespread child abuse in a British town reveals an institutional betrayal by police, social services and politicians. Negligent officials must face justice
August 30, 2014 -- Updated 0106 GMT (0906 HKT)
Peter Bergen and David Sterman say a new video of an American suicide bomber shows how Turkey's militant networks are key to jihadists' movement into Syria and Iraq. Turkey must stem the flow
September 1, 2014 -- Updated 1554 GMT (2354 HKT)
Whitney Barkley says many for-profit colleges deceive students, charge exorbitant tuitions and make false promises
August 29, 2014 -- Updated 1434 GMT (2234 HKT)
Mark O'Mara says the time has come to decide whether we really want police empowered to shoot those they believe are 'fleeing felons'
August 28, 2014 -- Updated 1432 GMT (2232 HKT)
Bill Frelick says a tool of rights workers is 'naming and shaming,' ensuring accountability for human rights crimes in conflicts. But what if wrongdoers know no shame?
August 29, 2014 -- Updated 0243 GMT (1043 HKT)
Jay Parini says, no, a little girl shouldn't fire an Uzi, but none of should have easy access to guns: The Second Amendment was not written to give us such a 'right,' no matter what the NRA says
August 30, 2014 -- Updated 1722 GMT (0122 HKT)
Terra Ziporyn Snider says many adolescents suffer chronic sleep deprivation, which can indeed lead to safety problems. Would starting school an hour later be so wrong?
August 29, 2014 -- Updated 1330 GMT (2130 HKT)
Peggy Drexler says after all the celebrity divorces, it's tempting to ask the question. But there are still considerable benefits to getting hitched
August 29, 2014 -- Updated 1849 GMT (0249 HKT)
The death of Douglas McAuthur McCain, the first American killed fighting for ISIS, highlights the pull of Syria's war for Western jihadists, writes Peter Bergen.
August 26, 2014 -- Updated 2242 GMT (0642 HKT)
Former ambassador to Syria Robert Ford says the West should be helping moderates in the Syrian armed opposition end the al-Assad regime and form a government to focus on driving ISIS out
August 27, 2014 -- Updated 1321 GMT (2121 HKT)
Ruben Navarrette says a great country does not deport thousands of vulnerable, unaccompanied minors who fled in fear for their lives
August 27, 2014 -- Updated 1319 GMT (2119 HKT)
Robert McIntyre says Congress is the culprit for letting Burger King pay lower taxes after merging with Tim Hortons.
August 26, 2014 -- Updated 2335 GMT (0735 HKT)
Wesley Clark says the U.S. can offer support to its Islamic friends in the region most threatened by ISIS, but it can't fight their war
August 26, 2014 -- Updated 2053 GMT (0453 HKT)
America's painful struggle with racism has often brought great satisfaction to the country's rivals, critics, and foes. The killing of Michael Brown and its tumultuous aftermath has been a bonanza.
August 26, 2014 -- Updated 1919 GMT (0319 HKT)
Rick Martin says the death of Robin Williams brought back memories of his own battle facing down depression as a young man
August 26, 2014 -- Updated 1558 GMT (2358 HKT)
David Perry asks: What's the best way for police officers to handle people with psychiatric disabilities?
August 25, 2014 -- Updated 1950 GMT (0350 HKT)
Julian Zelizer says it's not crazy to think Mitt Romney would be able to end up at the top of the GOP ticket in 2016
August 25, 2014 -- Updated 2052 GMT (0452 HKT)
Roxanne Jones and her girlfriends would cheer from the sidelines for the boys playing Little League. But they really wanted to play. Now Mo'ne Davis shows the world that girls really can throw.
August 25, 2014 -- Updated 2104 GMT (0504 HKT)
Kimberly Norwood is a black mom who lives in an affluent neighborhood not far from Ferguson, but she has the same fears for her children as people in that troubled town do
August 22, 2014 -- Updated 2145 GMT (0545 HKT)
It apparently has worked for France, say Peter Bergen and Emily Schneider, but carries uncomfortable risks. When it comes to kidnappings, nations face grim options.
ADVERTISEMENT