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.
CRE Infection (Carbapenem-Resistant Enterobacteriaceae Infection) Symptoms
The signs and symptoms of CRE infections vary depending on which organs are infected. Many patients will have a fever and signs of overwhelming infection (sepsis). When sepsis is present, symptoms can include low blood pressure, rapid heart rate, and fast respirations. Those with infections in their lungs may have cough or respiratory failure. Abdominal pain may be present in the cause of abdominal infections.
CRE Infection (Carbapenem-Resistant Enterobacteriaceae Infection) Causes
CRE infections usually do not occur in healthy individuals. They are more common in people living in nursing homes and in recently hospitalized people. These people have immune systems that weakened by other infections and illnesses. Many times, these people are on other antibiotics prior to developing the resistant infection with CRE. CRE infections also occur more commonly in those on ventilators or who have urinary bladder or intravenous catheters.
Bacteria are microscopic, single-cell organisms that live almost everywhere. Bacteria live in every climate and location on earth. Some are airborne while others live in water or soil. Bacteria live on and inside plants, animals, and people. The word "bacteria" has a negative connotation, but bacteria actually perform many vital functions for organisms and in the environment. For example, plants need bacteria in the soil in order to grow.
The vast majority of bacteria are harmless to people and some strains are even beneficial. In the human gastrointestinal tract, good bacteria aid in digestion and produce vitamins. They also help with immunity, making the body less hospitable to bad bacteria and other harmful pathogens. When considering all the strains of bacteria that exist, relatively few are capable of making people sick.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.