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A deadly superbug that kills about half of those it infects has been found spreading in Victoria's hospitals. It is believed to have killed at least two patients and may have caused the death of up to 18 others. Hospitals across the state have been put on high alert for the antibiotic resistant bacteria known as Carbapenem resistant Enterobacteriaceae (CRE) and ordered to observe strict infection control.
What is Carbapenem resistant Enterobacteriaceae (CRE)?
Enterobacteriaceae is the name given to a family of bacteria that normally lives in our bowel. The most well‑known Enterobacteriaceae is E. coli, which people can have naturally in their intestines. When they spread to other parts of the body, however, they can wreak havoc.
Carbapenems are a group of antibiotics that usually work against these bacteria. But, some bacteria have become resistant to these antibiotics. It's these bacteria which are called Carbapenem resistant Enterobacteriaceae (CRE).
How do you get CRE?
It is not spread through the air or by coughing or sneezing.
In Australia, CRE infections are rare. When people do get a CRE infection, it often has been picked up when the person has had medical care overseas. CRE is found in patients in hospitals and clinics around the world, but particularly in Greece, India and South‑East Asia.
Healthy people do not usually get CRE infections. People may carry CRE in their bowel or in a wound, without symptoms.
People who carry CRE are at risk of getting a CRE infection if they have an operation (especially on the prostate) or need treatment involving ventilators, catheters, or intravenous drips. People who have taken some antibiotics for long periods of time are also at risk of developing CRE infections.
Who is most at risk of getting CRE infections?
- People receiving multiple antibiotics;
- people undergoing complex surgery;
- people staying in an intensive care unit; and
- people having medical devices placed within their body, for example urinary catheters, ventilators or intravenous catheters.
Signs and symptoms
There is no specific "CRE disease".
The symptoms that develop with CRE infection are the ones you would get with any other bacterial infection such as:
- fever;
- feeling generally unwell;
- rapid pulse rate; and
- redness, swelling, pain or heat at a specific site.
In some cases CRE can enter the bloodstream, from either an existing infection such as an abscess or urinary tract infection or from a medical device such as a urinary catheter or intravenous catheter.
Symptoms of bloodstream infection are also not specific to CRE and can be the same as for other bacteria. Typically, signs and symptoms can include fever, shivering, and low blood pressure.
What does it mean to have CRE?
People may not know that they are carrying CRE and may never develop serious infection. However, in some people, CRE can become a serious problem and may cause pneumonia, abscesses, bloodstream infection, or many other types of infections and can sometimes result in death.
What happens if you have CRE?
If your doctor considers that you may carry or be infected with CRE, they will do some simple tests. This might involve taking a swab, blood or urine sample.
Treatment of CRE infections
There is no vaccination available to prevent you from acquiring CRE or treatment to eliminate CRE from your body. People colonised with CRE do not need to have any treatment or antibiotics.
If the CRE are causing infection, there are still some antibiotics that can be used.
Source: Australian Commission on Safety and Quality in Health Care, WA Department of Health
