Doctors have nightmares. They’re not the usual nightmares of sitting naked in Grade 12 Math class being taught by a stegosaurus as your teeth slowly fall out. Nope. We have nightmares about taking out the wrong kidney, taking out night nurses or ordering take out with a side of bacteria gone wild. Fortunately there are very few stegosauri left in schools but ladies and gentlemen, start your engines and get out of dodge. There is now a new superbug, a rogue bacteria gone wild. This one isn’t just super, it is super super, kryptonite resistant. Welcome to my nightmare bacteria Alice, the one we didn’t ever want to see, the one that NO antibiotic can touch.
Up to now, the superbugs you have heard of like MRSA, the NDM-1 plasmid of New Delhi, C. difficile etc., were not completely 100% resistant to every antibiotic. But this new one IS and if you’re not scared, get scared. It’s called CRE and it does CRE stuff but really, there are two things you should know about CRE:
Why is it here?
1. Antibiotic overuse. This is normally where I tee off and berate you, the patient, for coming to the clinic for antibiotics for a cold or flu or earache. But most of you folks have figured it out. In the past several years I’ve noted fewer requests for antibiotics and fewer people demanding treatment for a cold. There are still a few who do, of course. They apparently don’t think they should suffer with a cold while everyone else should. They want the instant magic cure we’ve been keeping to ourselves, often coming up with brilliant statements like:
“I simply can’t be sick doctor. I have to go on a trip to Drumheller to see the stegosaurus festival.”
“It starts in my head but it always goes to my chest.” Yes Bloggins, that’s what a cold does. But it’s still just a cold so get a grippe.
“Well, my doctor always gives me antibiotics.” In the past, weaker doctors may have given antibiotics for ear infections and coughs, but competent doctors do not.
As the world shrinks the medical problems expand. In third world countries where antibiotics are plentiful and education is not, antibiotics are being doled out like Kleenex at a Flames game. Compounding this is medical tourism. Folks scamper off to East Trumpastan for a really cheap tummy tuck or facelift or a tummy lift into a face tuck, when they’re on sale. While on this trip, they pick up a few falafels and a little CRE, bringing both back home. Though they may be asymptomatic they might still be colonized with CRE and falafel crumbs.
Many places now have special protocols in place to deal with sick patients who've come from places like Greece, the Middle East and the Indian subcontinent. But here is the scary part. There are now actually protocols in place for patients who have been in hospital in.... the USA! A couple of hundred hospitals in 41 US states now have confirmed cases of this deadly CRE.
The countermeasures include keeping patients isolated/quarantined as CRE is shed in the feces of patients who are infected or carrying the bacteria. Yet another good reason to stay away from hospitals and clinics unless you have to. Apparently there are sick people there. Can you catch something in the waiting room? Absolutely! If you use doorknobs, touch a chair or run your hands through the hair of the patient sitting beside you, you could catch a nasty bug. I recently had a patient lick the face of another patient sitting in the waiting room!
The blockbuster movie Contagion showed the entire world, or at least Toronto, grinding to a halt as an unstoppable microbe destroys the Blue Jays and most of the Leafs’ defense men. Could this actually occur? Possibly. This would mean that the Leafs will never again win Lord Stanley’s Cup prolonging the nightmare of those of us of Leaf Nation. Unless, of course, this year we happen to trade for a stegosaurus. That would be a dream come true.