Doctor's Notes on CRE Infection (Carbapenem-Resistant Enterobacteriaceae Infection)
CRE infection (carbapenem-resistant Enterobacteriaceae infection) is a condition where a bacterial species causes an infection and produces enzymes that break down carbapenem antibiotics so that the bacteria are resistant to the antibiotics. Signs and symptoms vary with the area or organ system infected. CRE infections often develop severe symptoms as follows:
- Shortness of breath
- Septic shock
- Fever and chills
- Abdominal (belly) pain
- Painful swelling of skin
- Painful urination
- Stiff neck
- Reduced consciousness
The bacteria that causes CRE infections usually infect people who are immune compromised and who are often already on antibiotics. The bacterial genera that may cause CRE are as follows:
Lab tests can determine if bacteria are carbapenem resistant (CRE). Treatment depends on treating the patient with multiple antibiotics to which the bacteria may be susceptible. Unfortunately, CRE bacteria are often resistant to multiple antibiotics. The CDC suggests that about half of patients with CRE infections will die despite treatment.
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Fever (in Adults)A fever is a body temperature of 100.4 F or greater. A fever may be caused by a virus, bacteria, fungus, blood clot, tumor, drug, or the environment. Treatment of fever in adults usually involves ibuprofen, acetaminophen, or aspirin.
Fever in ChildrenFever is defined as a rectal temperature over 100.4 F or 38 C. Fever isn't life-threatening unless it is persistently high - greater than a 107 F rectal temperature. Fever is usually caused by an infection. Treatment focuses on controlling the temperature, preventing dehydration, and monitoring for serious illness.
Low Blood Pressure (Hypotension)Low blood pressure (hypotension) may be caused by heart conditions, intravascular fluid complications (dehydration, pneumonia, vomiting, diarrhea, bleeding), medications, endocrine conditions, allergic reactions, orthostatic hypotension, diabetes, and micturition syncope. Low blood pressure may or may not have symptoms depending upon the cause. Treatment also depends upon the causes of low blood pressure.
Sepsis (Blood Infection)Sepsis is a blood infection caused by bacteria, viruses, or fungi. Immunocompromised individuals, very young babies, and the elderly are most at risk for developing sepsis. Symptoms and signs include chills, shaking, fever, rapid heartbeat, confusion, rash, and joint pain. Treatment depends upon the severity of the infection and may involve the patient being placed on oxygen and given IV antibiotics and saline.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.