Deadly for Nursing Home Seniors... What is the 'CRE Infection' Causing Increased Deaths?

Carbapenem-Resistant Enterobacteriaceae (CRE) Infections
Mortality Rate Increased About 17 Times Compared to 2017
"Strict Management of Antibiotic Resistance Is Essential"

The mortality rate of carbapenem-resistant Enterobacteriaceae (CRE) infections, which are difficult to treat and have a high fatality rate, has been rapidly increasing both domestically and internationally.

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According to data received by Park Heeseung, a member of the National Assembly's Health and Welfare Committee from the Korea Disease Control and Prevention Agency on the 21st, death reports due to CRE infections have continuously increased from 37 cases in 2017 to 663 cases last year, a 17-fold rise. Reported cases also increased 6.7 times from 5,717 in 2017 to 38,405 last year. This year, as of June, reported cases reached 25,533 and death reports 439, with projections estimating nearly 50,000 reported cases and 900 deaths by the end of the year.

CRE infections are caused by bacteria resistant to carbapenem antibiotics, commonly referred to as "superbugs." The problem stems from multidrug-resistant bacteria (MDR) arising due to antibiotic misuse and incorrect prescriptions during treatment of bacterial infections such as urinary tract infections. Since antibiotic resistance of the causative bacteria varies by region, gender, and age, appropriate empirical antibiotic prescriptions and proper usage are necessary. Additionally, accurate medical history taking, general physical examinations, and urine culture tests must be conducted to confirm the presence of the causative bacteria.

CRE infection is a disease caused by bacteria resistant to carbapenem antibiotics, commonly referred to as 'superbugs.' [Unrelated stock photo]

Recently, the medical community has focused on the fact that CRE infections mainly occur in the elderly population. Among the 25,533 CRE patients in the first half of this year, 19,932 (78%) were aged 65 to 90. Urology specialists pointed out that this concentration in the elderly is due to antibiotic misuse in nursing hospitals and neglect of elderly urinary management. According to a paper published last year by Professor Lee Yeonju’s team from the Department of Respiratory Medicine at Bundang Seoul National University Hospital, inappropriate use of antibiotics for bacterial infections occurring in nursing hospitals or long-term care facilities was found to be very high. The rates were about 35% in long-term care facilities and 24% in nursing hospitals.

Assemblyman Park emphasized, "Infections with antibiotic-resistant bacteria lead to longer hospital stays and increased mortality, resulting in higher medical costs," and added, "It is essential to expand participation of chronic care hospitals such as nursing hospitals in the nationwide medical-related surveillance system (KONIS) to thoroughly manage antibiotic resistance in urinary tract infections."