Bacteria may be spreading more stealthily than existing surveillance can detect.

Researchers from Harvard and the Broad Institute of MIT found that the class of bacteria, CREs — short for carbapenem-resistant Enterobacteriaceae — has more ways to evade antibiotics than have been currently identified, and that these bugs share their tricks readily across the families of bacteria that make up this grouping.

Further, the authors suggest these bacteria may be spreading more stealthily than existing surveillance can detect.

“You know the phrase ‘Shutting the stable door after the horse has bolted?’ The horse has not only bolted, the horse has had a lot of ponies, and they’re eating all our carrots,” said Bill Hanage, an infectious diseases epidemiologist at the Harvard T.H. Chan School of Public Health and senior author of the study.

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Hanage and colleagues from Harvard and the Broad Institute of MIT and Harvard took an in-depth look at CREs recovered from patients in three Boston hospitals and a hospital in Irvine, Calif. Their findings are published this week in the Proceedings of the National Academy of Sciences.

Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, has dubbed CREs “nightmare bacteria.”  That’s because they are resistant to many, and sometimes most, antibiotics, including carbapenems, an important class of last-resort drugs.

They also have the capacity to transfer resistance genes from one family to the next — for instance from E. coli bacteria to Klebsiella pneumoniae. Think of it as gangs in a neighborhood teaching each other all their worst tricks.

Read the full article here.

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