HealthDay News — Drug-resistant carbapenem-resistant Enterobacteriaceae (CRE) cases have seen a five-fold increase at community hospitals in the southeastern United States, according to researchers.

“Although CRE are still relatively uncommon in the United States, the rate of carbapenem resistance among Enterobacteriaceae is increasing,” wrote Joshua T. Thaden, MD, PhD, and colleagues in Infection Control and Hospital Epidemiology.

CRE isolates from 25 community hospitals were prospectively entered into a centralized database from January 2008 through December 2012. The researchers examined the effect of lower carbapenem breakpoints on CRE detection.

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A total of 305 CRE isolates were detected at 16 hospitals (64%). Patients with CRE had symptomatic infection in 180 cases (59%) and asymptomatic colonization in the remainder (125 cases; 41%).

Greater use of broad-spectrum antibiotics and increased transmission between long-term acute care facilities and community hospitals were named factors associated with the growing number of CRE infections

CRE bacteria can cause infections in the urinary tract, lungs, blood, and other areas. The death rate from CRE infections is nearly 50%.

“The relatively low rate of CRE detection among the community hospitals in this study punctuates the importance of using networks of hospitals to identify larger epidemiologic trends and to better understand the importance of microbiology laboratory practices in detecting these pathogens,” wrote the researchers.


  1. Thaden J et al. Infection Control and Hospital Epidemiology. 2014; doi: 10.1086/677157