A glossary of terms, bacteria, and drugs commonly associated with CRE infections and coverage of said infections. 

Amino glycoside ­ – A category of antibacterial agents that have shown activity in killing gram ­negative antibiotic resistant bacteria.

Antibiotics ­ – Antibiotics are powerful medicines that are used in medical treatment to fight bacterial infections by either killing bacteria or keeping them from reproducing.

Antibiotic Resistance­ – Antibiotic resistance occurs when bacteria change in some way that reduces the effectiveness of antibiotics. Often, the bacteria begin to produce enzymes neutralize certain antibiotics.

Carbapenem­-resistant Enterobacteriaceae (CRE) ­- CRE are a family of bacteria that have developed extremely high levels of resistance to antibiotics, including carbapenem.

Carbapenem ­- A broad spectrum class of beta­lactam antibiotics that is often considered a “last line of defense” against serious infections. They are effective against most antibiotic resistant bacteria with the exception of CRE.

Carbapenemase ­ – An enzyme produced by CRE bacteria that breaks down carbapenem class antibiotics and renders them ineffective. There are several strains of carbepenemase, including KPC, MBL, NDM, and VIM.

Ceftazidime avibactam ­- A new antibacterial drug used to treat intra-­abdominal, urinary tract, and kidney infections. It has shown the ability to inhibit the activities of several CRE bacteria.

Duodenoscope ­ – A long, thin flexible medical instrument used in a procedure called endoscopic retrograde cholangiopancreatography (ERCP). It has many channels and moving parts that make it difficult to sterilize.

Endoscopic retrograde cholangiopancreatography (ERCP) ­ – An endoscopic procedure that is used to diagnose and treat problems of the bile and pancreatic ducts.

Enterobacteriaceae ­- A large family of gram­ negative bacteria that include salmonella, E. Coli, klebsiella, shigella, enterobacter, and many other species. E. Coli and klebsiella are often found in the gut of healthy people, but can become resistant to carbapenem.

Fosfomycin ­ – An antibiotic used to treat infections in the urinary tract. Many CRE strains are susceptible to fosfomycin.

Gram negative bacteria ­ – Bacteria that give a negative result in the Gram stain test ­ due to a thin peptidoglycan layer in their cell wall. Gram negative bacteria have built ­in abilities to become resistant to and pass on genetic materials that allow other bacteria to become resistant to antibiotics. These bacteria can cause infections in the bloodstream, at surgical or wound sites, cause pneumonia, or even meningitis.

Gram positive bacteria ­ – Bacteria that give a positive result in the Gram stain test ­ due to a thick peptidoglycan layer in their cell wall. Gram positive bacteria are generally more susceptible to antibiotic treatments.

Healthcare Associated Infection (HAI) ­ – Infections that patients acquire or develop during the course of receiving healthcare treatment for other conditions. They often happen in hospitals, long term care facilities, and surgery or dialysis centers. HAI’s currently occur in 1 in 25 patients.

Klebsiella pneumoniae carbapenemase (KPC) ­ – The most common carbapenemase among CRE bacteria in the United States.

Metallo Beta­lactamases (MBL) ­ – A strain of carbapenemase enzyme that is found worldwide.

New Delhi MBL (NDM) ­ – A particular strain of MBL that originated in India and has been found in many hospitals there and most recently in drinking water around New Delhi. In the United States, it has been found in patients that visited India as “medical tourists”.

Polymyxins ­ – Antibiotics used to help treat CRE infections that disrupt the bacterial cell membrane.

Superbugs ­- Strains of bacteria that have developed resistance to several types of antibiotics. CRE, for example, is considered a “nightmare” superbug, making it extremely difficult to treat.

Temocillin ­- A type of penicillin that is resistant many forms of beta­lactamase and is used to help treat CRE infections.

Tigecycline ­ – An injectable antibiotic that prevents bacteria from multiplying by binding ribosomes of bacteria. It does not kill any bacteria, however.

Verona integron­encoded MBL (VIM) – A strain of carbapenemase enzyme that is rare in enterobacteriaceae.  It is more commonly found in Europe and the far east.