Six people in Colorado were recently reported to have the "nightmare superbug," according to the Centers for Disease Control and Prevention (CDC).

Carbapenem-resistant Enterobacteriaceae (CRE) are considered superbugs that are mostly contracted by individuals who stay or have stayed in healthcare facilities, or have had invasive medical procedures done.

'Nightmare Superbug' Spreading Beyond Hospitals?

In these recent cases, however, the superbug appears to have been contracted by the patients outside a facility as none of them reported staying in a healthcare facility or undergoing any medical procedures in the year prior to the contraction of the superbug.

Cases of CRE have been reported in Colorado as early as November 2012. Between 2014 and 2016, 10 cases of the superbug were reported; six of which lacked the risk factors of CRE such as a recent hospitalization, surgery, dialysis or having invasive devices in the preceding two days.

Among the six community-associated patients, two of them reported international travel in an unknown country in Africa and the Bahamas. However, all six of them were diagnosed with Urinary Tract Infections, and three of them had reported exposure to antibiotics.

What Makes The CRE A Superbug?

Carbapenem-resistant Enterobacteriaceae are considered an urgent healthcare threat to the U.S. population because of the high morbidity and mortality rates they yield; limited treatment options; and a potential for a rapid spread among patients.

Carbapenemases are enzymes that are resistant to carbapenem, a powerful class of antibiotics. It is resistant to most drugs, is highly lethal, and can kill up to half of infected patients.

An important risk factor for CRE infections is the intake of antibiotics. A disturbance of the bacteria in the gut, which is what happens when antibiotics are taken, puts people at risk of developing bad bacteria including CRE.

Studies have also shown that the misuse of antibiotics can lead to antimicrobial resistance, which is when various bacteria, viruses, fungi, and parasites change when exposed to the antibiotics. This makes the microorganisms immune to drugs. Treatments become more complicated with lengthier stays in the hospital, and major surgeries become high risk.

The emergence of six community-associated CRE patients may suggest that the epidemiology of the bug is changing, but further observation is being done to determine if the pattern continues.

As with most infections, prevention begins with frequent handwashing and good hygiene on the part of both the public and healthcare providers, especially when undergoing healthcare procedures.