There’s a new super bug in town, but it’s not a super hero.  The Centers for Disease Control and Prevention is alerting clinicians of an emerging untreatable multidrug-resistant organism in the United States. The CDC said the increase in CRE means health care providers need to “act aggressively to prevent the emergence and spread of these unusual CRE organisms.”  Upon reading this, I immediately requested that my daughter Alexandra who just happens to be a Molecular and Cellular Biologist to dissect this and explain the ramifications and solutions using terminology we can understand.  Below is Alexandra’s explanation:

“There are a lot of strains of Enterobacteriaceae, the ones they’re talking about have a plasmid containing NDM-1 on it.  NDM-1 was discovered back in 09 in a Klebsiella species.  The big thing about NDM-1 (which is short hand for New Delhi metallo-beta-lactamase) is that it can disrupt the beta lactam ring in both old and new antibiotics meaning that its very difficult to deal with an infection because we don’t really have anything to fight it with.  The gene is on an extrachromosomal piece of DNA so it can be transmitted to other species which is most likely why were finding it in Enterobacter species when we originally found it in Klebsiella.  We already have a good deal of Enterobacter species in our intestines that help out with digestion so it wouldn’t be hard for someone to come in contact with a source of NDM-1 carrying Enterobacters that would have an easier time surviving in human intestines than a lot of other species because of an existing Enterobacter population.  However, that’s not the most worrisome part, there is a chance that Enterobacter can come in contact with bacteria already present in the human microflora and spread the NDM-1 gene through conjugation to a species like E. Coli which will readily accept DNA through conjugation.  So in the end using any type of antibiotic will actually favor the survival of a species containing NDM-1 and can even clear up space by killing off other bacterial strains that aren’t resistant to allow these carriers to spread even faster. Really the only way to fight something like this is prevention because Dr.’s don’t have anything to use against them.”

“Our strongest antibiotics don’t work and patients are left with potentially untreatable infections.”   Dr. Tom Frieden, director of the CDC

Here is an excerpt from the latest info I could find which confirms what Alexandra has explained.  The bacteria belong to the Enterobacteriaceae family, which includes more than 70 species that normally live in the water, soil and human digestive system, such as the well-known E. coli. Over the years, some Enterobacteriaceae have become resistant to all or almost all antibiotics, including last-resort drugs known as carbapenems. Over the past decade, the percentage of Enterobacteriaceae that are resistant to these last-ditch antibiotics rose by 400 percent. One type of CRE, a form of Klebsiella pneumoniae, has increased sevenfold in the last decade.  When the antibiotics wipe out susceptible bacteria, the coast is clear for CRE to proliferate.
Essentially our only control mechanism and defense is prevention.  Wash your hands thoroughly, avoid touching your mouth or eyes with unwashed hands, especially after touching the usual germ carrying vehicles:  door knobs, light switches, cell phones, countertops, etc…HMMM? Sounds like cleaning for health and hygiene is the answer.

Thanks to the following for their contribution:

Alexandra Heuvelman ~Molecular Cellular Biologist, B.S. Univ. of Il.Champ / Urb

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