Submitted by
Lois Rain on March 31, 2011 – 5:56 pm
This is possibly our biggest infection control dilemma yet.
Although cases of this bacterial infection has been on the rise
worldwide for the last 10 years, there is an alarming spread
recently across the US. Thirty-five states have reported the
outbreak, but there could be more in states not required to report
it. What makes this opportunistic “superbug” such a nightmare is
that it is Carbapenem-Resistant, meaning “last resort antibiotic”
resistant. It’s a Carbapenem-Resistant Klebsiella pneumoniae (CRKP);
Klebsiella pneumoniae is a strain of Klebsiella which is related to
E. Coli and Salmonella from the family Enterobacteriaceae.
Found inside the gut, outside of the gut, it can cause lethal
infection. The major reservoirs of infection are the
gastrointestinal tract of patients, catheters, unclean instruments,
and the hands of hospital personnel. It zeros in on hospitals, ICUs,
long term care faciities like nursing homes, and those with
immuno-compromised conditions. It is a potential community-acquired
type of pneumonia (different, not acquired from hospitals) and the
bug has an incredible ability to mutate and resist. It does indeed
carry a fatality rate between 35 and 50 percent or more.
Are we just to avoid hospitals and nursing homes to keep from
this public threat? While CRKP and other resistant strains laugh in
the face of antibiotics, there is some glimmer of hope. As of 2005,
the EPA registered chlorine dioxide (aka MMS) as a disinfectant for
MRSA. Pathogens cannot resist it and it does not harm humans. Unlike
bleach, it requires very small concentrations, and leaves no
residue. It completely breaks down thick cell walls which is one of
the reasons these superbugs are so resistant.
As of 2006, Purdue University researchers found that besides
laser detection technology,
“A second innovation uses chlorine dioxide gas to kill
pathogens on produce, fresh fruits and vegetables. This would be
a large step up from current technologies, which mainly involve
washing and scrubbing, and cannot completely rid a product of a
pathogen like E. coli,” said Richard Linton, a professor of food
science.
“We can use the laser technology to detect problems more
quickly, determine exactly what the pathogen is and where it
came from,” Linton said. “As for using this gas as a
disinfectant, I would say that in my 13 years of doing research,
it is 10,000 to 100,000 times more effective than any process I
have seen.”
It is not clear at this time if hospitals are rigorously
trying to control the bug with this disinfectant. Let’s hope that
hospitals, nursing homes and others not forget this lifesaving
preventative and controller.
~Health Freedoms
The CDC and LA Times reports a “Superbug” that kills 40%
of the people it comes in contact with has hit 35 US States and is
now being spread through California medical facilities.
LA Times:
A dangerous drug-resistant bacterium has spread to patients
in Southern California, according to a study by Los Angeles
County public health officials.
More than 350 cases of the Carbapenem-Resistant Klebsiella
pneumoniae, or CRKP, have been reported at healthcare
facilities in Los Angeles County, mostly among elderly patients
at skilled-nursing and long-term care facilities, according to a
study by Dr. Dawn Terashita, an epidemiologist with the Los
Angeles County Department of Public Health.
It was not clear from the study how many of the infections
proved fatal, but other studies in the U.S. and Israel have
shown that about 40% of patients with the infection die.
Tereshita was not available for comment Thursday morning but was
scheduled to speak about the study in the afternoon.
Here’s a map from the CDC of states where it has been reported:
The Centers for Disease Control Writes:
Public Health update of
Carbapenem-Resistant Enterobacteriaceae (CRE) producing
metallo-beta-lactamases (NDM, VIM, IMP) in the U.S. reported to
CDC
Given the importance of Enterobacteriaceae in
healthcare-associated infections (HAI) and the extensive
antimicrobial resistance found in these strains, all types of
carbapenem-resistant Enterobacteriaceae (CRE) are an important
public health problem, regardless of their mechanism of
resistance or their country of origin. In addition,
as Enterobacteriaceae are a normal part of human flora, the
potential for community-associated CRE infections also exists.
Carbapenem-resistance in Enterobacteriaceae can occur by many
mechanisms, including the production of a metallo-beta-lactamase
(such as NDM, VIM, and IMP) or a carbapenemase (such
as Klebsiella pneumoniae carbapenemase, KPC).
CDC has been working with partners to prevent CRE infections,
including those caused by KPC-producing organisms, which are the
most common type of CRE in the United States. The KPC gene
makesEnterobacteriaceae bacteria resistant to all
beta-lactam/carbapenem antibiotics. KPC producers have been
reported in about 35 states and are associated with high
mortality, up to 40 percent in one report. They may be present
in the other 15 states as well, but have not been reported to
CDC. The presence of CRE, regardless of the enzyme that
produced that resistance, reinforces the need for better
antibiotic stewardship, transmission prevention, and overall HAI
prevention in any healthcare setting.
The detection of new mechanisms of carbapenem resistance (ie,
metallo-beta-lactamases) in the United States has raised
questions about the identification and control of CRE. The
mechanism of carbapenem-resistance is of epidemiologic interest
but is not necessary for implementation of infection prevention
recommendations. Current guidance for the control of all types
of epidemiologically important multidrug-resistant organisms is
available in the2006 MDRO Guideline. In addition, see specific
guidance for the control of CRE. These recommendations apply
regardless of the resistance mechanism.
It is important to note that CRE, unlike other drug-resistant
infections such as VRSA, are not a nationally reportable or
notifiable disease. Therefore, there is not a requirement to
report to CDC and therefore we may not know the true number of
infections caused by these organisms in the US (only those
voluntarily reported to CDC).
States with confirmed CRE cases caused by the KPC enzyme.
Alabama
Arizona
Arkansas
California (CRE caused by the NDM-1 enzyme and VIM or
IMP enzyme)
Colorado
Delaware
Florida
Georgia
Illinois (CRE caused by the NDM-1 enzyme)
Indiana
Iowa
Kentucky
Louisiana
Maryland
Massachusetts (CRE caused by the NDM-1 enzyme)
Michigan
Minnesota
Mississippi |
Missouri
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
Ohio
Oregon
Pennsylvania
South Carolina
Tennessee
Texas
Utah
Virginia (CRE caused by the NDM-1 enzyme)
West Virginia
Wisconsin
Wyoming |
State(s) with confirmed CRE cases caused by a VIM or IMP
enzyme
Washington
By Alex Higgins, The Intel Hub
http://www.infowarhorse.com/cdc-%E2%80%9Csuperbug%E2%80%9D-speads-to-35-states-kills-upwards-of-40of-the-people-who-come-in-contact/
Sources:
http://news.uns.purdue.edu/html4ever/2006/061005LintonFood.html
http://www.shareclean.com/news/new21.html
http://www.ourfood.com/General_Bacteriology.html#S051140000
http://www.medicalnewstoday.com/articles/30105.php
http://www.medicalnewstoday.com/articles/205672.php
http://www.cdc.gov/ncidod/eid/vol8no2/01-0025.htm
http://www.cdc.gov/ncidod/eid/vol8no2/01-0025.htm
http://latimesblogs.latimes.com/lanow/2011/03/superbug-spreading-to-southern-california-hospitals.html
http://www.cdc.gov/HAI/organisms/cre.html
Health Freedom Alliance
Health & Wellness Foundation
CHAD Foundation
http://www.