Arjun Srinivasan, MD, Associate Director for Healthcare Associated Infection Prevention Programs for the CDC, agreed to answer a few questions about what is known, and not known, about CRE.
Arjun Srinivasan, MD, (Photo credit: CDC)
HLM: The latest reports on cases are from January through June of 2012. Can you expand on how CRE cases are trending today?
AS: We don't have anything more recent than what was published in Vital Signs. But certainly what that data suggests is that there is an alarming increase in the frequency with which hospitals are encountering patients, and [admitting] patients who develop infections with CRE.
HLM: With only 4.6% of hospitals reporting this, might it seem that it's not that significant? How many have you documented?
AS: We didn't publish a number of cases. We don't have numbers. We are working on getting a better sense of the burden of this, and get a number. But we think it's important for people not to dwell on the number. Is it 400 or 500 or 10,000? Whatever it is, it's too many. We need people to take action to keep it from getting larger.
HLM: What percentage of patients who have colonized CRE will develop a bloodstream infection, which you mention will be fatal in half of these patients?
AS: We don't know for sure. We know that being colonized increases the risk of a bloodstream infection.
HLM: That's odd for the CDC, which usually gets good numbers for emerging infections rather quickly.
AS: We're working on it. There are many conditions for which we have numbers, and there are many for which we don't and this is one. We're working hard to gather more information to make estimates of how many people are developing these infections in addition to knowing how many hospitals are seeing this.