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
November 19, 2014 -- Updated 2011 GMT (0411 HKT)
Lost in much of the coverage of ISIS brutality is how successful the group has been at attracting other groups, says Peter Bergen.
November 19, 2014 -- Updated 1345 GMT (2145 HKT)
Do recent developments mean that full legalization of pot is inevitable? Not necessarily, but one would hope so, says Jeffrey Miron.
November 19, 2014 -- Updated 1319 GMT (2119 HKT)
We don't know what Bill Cosby did or did not do, but these allegations should not be easily dismissed, says Leslie Morgan Steiner.
November 19, 2014 -- Updated 1519 GMT (2319 HKT)
Does Palestinian leader Mahmoud Abbas have the influence to bring stability to Jerusalem?
November 19, 2014 -- Updated 1759 GMT (0159 HKT)
Even though there are far fewer people being stopped, does continued use of "broken windows" strategy mean minorities are still the target of undue police enforcement?
November 18, 2014 -- Updated 0258 GMT (1058 HKT)
The truth is, we ran away from the best progressive persuasion voice in our times because the ghost of our country's original sin still haunts us, writes Cornell Belcher.
November 18, 2014 -- Updated 2141 GMT (0541 HKT)
Children living in the Syrian city of Aleppo watch the sky. Not for signs of winter's approach, although the cold winds are already blowing, but for barrel bombs.
November 17, 2014 -- Updated 1321 GMT (2121 HKT)
We're stuck in a kind of Middle East Bermuda Triangle where messy outcomes are more likely than neat solutions, says Aaron David Miller.
November 17, 2014 -- Updated 1216 GMT (2016 HKT)
In the midst of the fight against Islamist rebels seeking to turn the clock back, a Kurdish region in Syria has approved a law ordering equality for women. Take that, ISIS!
November 17, 2014 -- Updated 0407 GMT (1207 HKT)
Ruben Navarrette says President Obama would be justified in acting on his own to limit deportations
November 17, 2014 -- Updated 1321 GMT (2121 HKT)
America will have its hands full in the Middle East for years to come, writes Aaron David Miller.
November 15, 2014 -- Updated 1617 GMT (0017 HKT)
Gene Seymour says it's part of our pioneering makeup to keep exploring the universe
November 14, 2014 -- Updated 1742 GMT (0142 HKT)
Sally Kohn says the U.S.-China agreement to cut carbon emissions is a big deal, and Republicans should take note.
November 15, 2014 -- Updated 2129 GMT (0529 HKT)
S.E. Cupp says the Obamacare advisor who repeatedly disses the electorate in a series of videotaped remarks reveals arrogance and cluelessnes.
November 14, 2014 -- Updated 2200 GMT (0600 HKT)
Reggie Littlejohn says gendercide is a human rights abuse against women, with bad consequences for nations.
November 13, 2014 -- Updated 1657 GMT (0057 HKT)
The massing of Russian forces near Ukraine only reinforces the impression that Moscow has no interest in reconciliation with the West, writes Michael Kofman.
November 12, 2014 -- Updated 1455 GMT (2255 HKT)
It takes a real man to make the moves on the wife of the most powerful man in the biggest country. Especially when the wife is a civilian major general.
November 12, 2014 -- Updated 1347 GMT (2147 HKT)
Proponents of marriage equality LGBT persons have been on quite a winning streak -- 32 states and the District of Columbia now allow same-sex marriage.
November 13, 2014 -- Updated 1358 GMT (2158 HKT)
It has been an eventful few weeks for space news.
November 12, 2014 -- Updated 2014 GMT (0414 HKT)
It's too early to write the U.S. off, and China's leaderships knows that better than anyone, argues Kerry Brown.
November 12, 2014 -- Updated 1821 GMT (0221 HKT)
"How can Jon Stewart hire you to be 'The Daily Show''s senior Muslim correspondent when you don't even know how to pronounce Salaam Al-aikum?!"
November 11, 2014 -- Updated 1231 GMT (2031 HKT)
Ruth Ben-Ghiat says WWI enshrined the enduring notion that words cannot adequately express the experience of combat -- that the veteran will often remain silent about the trauma of war.
November 11, 2014 -- Updated 2227 GMT (0627 HKT)
Obama's Asia trip is his first chance since the midterms to show the power of presidency, Michael Green says.
November 11, 2014 -- Updated 1234 GMT (2034 HKT)
Frida Ghitis asks why President Obama has written another letter to Iran's Supreme Leader about the nuclear deal.
ADVERTISEMENT