A total of 221 cases of carbapenem-resistant Enterobacteriaceae (CRE) were confirmed in US healthcare facilities in 2017, according to the Centers for Disease Control and Prevention (CDC).

These virulent pathogens, described by the CDC as “nightmare bacteria,” are very difficult to treat and control.

“While antibiotic resistance threats vary nationwide, [antibiotic resistance] has been found in every state,” the CDC stated. Using preventive measures for antibiotic resistant strains is the most effective treatment.

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The CDC reported that aggressive, early approaches to each case of infection can hinder high-resistance microbes from spreading, which could be untreatable if left uncontrolled. Since virulent microorganisms rapidly spread at exponential rates, such tactics could prevent 1600 CRE-related cases per state during the course of 3 years.

Healthcare facilities are strongly encouraged to contact their state/local lab support when resistant microorganisms are detected. Labs should send the proper isolates out immediately for testing and generate protocols to inform the proper departments about the microbe of interest and validate new tests to confirm and control the spread of the pathogen.

Health departments and healthcare facilities must enforce infection control within their facilities and monitor patients with these nightmare bacteria, according to the CDC. Ongoing colonization screenings and infection control should be a priority until pathogenic spreading is controlled.

In addition, the CDC made recommendations for everyone to “practice good hygiene, such as keeping hands clean with handwashing or alcohol-based hand rubs, and keep cuts clean until healed.”

By further detecting and increasing thorough early responses to antibiotic-resistant “nightmare bacteria,” the spread of future virulent microorganisms may be prevented, researchers reported in the CDC’s Morbidity and Mortality Weekly Report.

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Kate Russell Woodworth, MD, of the Division of Healthcare Quality Promotion at the National Center for Emerging and Zoonotic Diseases, at the CDC, and associates studied infection trends from the National Healthcare Safety Network from 2006 to 2015 to review and compare microbe resistance due to extended-spectrum β-lactamases (ESBLs) and carbapenemases.

The investigators found that Enterobacteriaceae with phenotypic ESBL decreased by 2% annually (risk ratio [RR], 0.98), while the CRE strains decreased 15% annually (RR, 0.85).

“The proportion of Enterobacteriaceae infections that were CRE remained lower and decreased more over time than the proportion that were ESBL phenotype,” wrote the authors.


  1. Woodworth KR, Walters MS, Weiner LM, et al. Vital signs: Containment of novel multidrug-resistant organisms and resistance mechanisms- United States, 2006-2017. [Published online April 3, 2018]. Morb Mortal Wkly Rep. doi:10.15585/mmwr.mm6713e1
  2. Containing unusual resistance. Atlanta, GA: Centers for Disease Control and Prevention. https://www.cdc.gov/vitalsigns/containing-unusual-resistance/index.html. Updated April 3, 2018. Accessed April 10, 2018.

This article originally appeared on Clinical Advisor