CRE (right) can grow in the presence of antibiotics CDC

The drug-resistant carbapenem-resistant Enterobacteriaceae (CRE) may be capable of spreading in more ways—and more insidiously—than previously thought, according to a study published January 16 in PNAS. CREs are resistant to multiple antibiotics including last-resort drugs like carbapenem, and have been called “nightmare” bacteria by Tom Frieden, director of the Centers for Disease Control and Prevention.

Researchers at the Broad Institute of MIT and Harvard analyzed 250 CRE samples from patients across four US hospitals, three in Boston and one in California. They found that the bacteria not only displayed remarkable genetic diversity and a variety of carbapenem resistance genes, but they were able to transfer resistance genes between species.

Although the researchers were unable to find much evidence of person-to-person transmission, CREs may be spreading without causing any symptoms. “The most common source of transmission with CRE is asymptomatic,”...

"While the typical focus has been on treating sick patients with CRE-related infections, our new findings suggest that CRE is spreading beyond the obvious cases of disease,” said coauthor Bill Hanage of the Harvard T.H. Chan School of Public Health, in a statement. "We need to look harder for this unobserved transmission within our communities and healthcare facilities if we want to stamp it out.”

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