Austin Public Health released a statement Feb. 1 warning the public of increasing cases of Carbapenem-Resistant Enterobacteriaceae, an antibiotic-resistant super bacteria, in Travis County hospitals. 

Kristin Mondy, chief of the Division of Infectious Diseases at Dell Medical School, said Enterobacteriaceae are a class of bacteria that includes E. coli and normally live in the gastrointestinal tract. 

“If Enterobacteriaceae get in the wrong place, like the urinary tract or in sites of recent surgeries, they can give rise to infections,” Mondy said. 

Mondy said those infections often include urinary tract infections and even bloodstream infections. While these can be treated with strong antibiotics like Carbapenem, Travis County has noticed an increase in cases where the bacteria is resistant. 

Because there are very few treatments available beyond Carbapenem, when bacteria becomes resistant, common infections can be life-threatening, Mondy said. 

Mondy said the warning should not alarm college students and the general public, because it is not easily spread among healthy individuals. Travis County reported four cases in both 2015, 13 in 2016 and 18 in 2017. Data for 2018 is still being finalized. 

Renee Fleeman, a postdoctoral fellow in the department of molecular biosciences, said bacteria are innately built to develop a resistance to anything opposing them.

“(Bacteria) mutate their genome very rapidly when they encounter a stress that is killing them,” Fleeman said. “In the context of Enterobacteriaceae, the stress is antibiotics.”

This change in the bacteria’s genetic material allows them to resist the antibiotic and survive to produce more antibiotic-resistant bacteria, Fleeman said. 

The FDA has not approved new antibiotics for Enterobacteriaceae since the early 1980s, Fleeman said.

Carbapenem usage is limited to minimize the possibility of bacterial resistance, Mondy said.

Betsy Kirkpatrick, founder of the Travis County Carbapenem-Resistant Enterobacteriaceae Task Force, said she started the task force in May 2018 to try to prevent another major increase in CRE cases in the Travis County area. 

One of the task force’s biggest goals is to educate physicians on the careful usage of antibiotics, as well as to educate the public and patients on the function of antibiotics, Kirkpatrick said. 

“Antibiotics are not always the answer, and patients should not pressure physicians to prescribe antibiotics,” Kirkpatrick said. 

It is important to act while CRE numbers are still low, Kirkpatrick said. 

“To be clear, we don’t have an outbreak situation in Travis County,” Kirkpatrick said. “We have an opportunity to stop the spread now if we work together.”