Commonly found in soil and water. Outbreaks typically occur in intensive care units. These infections rarely occur outside of healthcare settings.
At risk: Hospitalized patients, especially very ill patients on a ventilator, those with a prolonged hospital stay, those who have open wounds, or any person with invasive devices like urinary catheters.
Symptoms: Causes a variety of diseases, ranging from pneumonia to serious blood or wound infections, and the symptoms vary depending on the disease.
How it spreads: Person-to-person contact or contact with contaminated surfaces.
Clostridium difficile (c. diff)
Kills about 14,000 people per year. Although some hospital-associated infections are waning, levels of c. diff infections are at historic highs.
At risk: Older adults in long-term care, particularly those who must take antibiotics for a long time. Half of cases occur in people under 65, but 90 percent of deaths occur in people over 65.
Symptoms: Fever, diarrhea, nausea, loss of appetite, abdominal pain or tenderness.
How it spreads: c. diff is found in feces; people who touch surfaces or items contaminated with feces and then touch their mouths or mucous membranes may contract infection. Healthcare workers spread the bacteria to patients or contaminate surfaces through hand contact.
Carbapenem-resistant Enterobacteriaceae (CRE)
First noted in the U.S. in 2001, CRE kills up to 50 percent of those it infects. Carbapenems are antibiotics used to treat serious infections. Enterobacrteriaceae includes E. coli and Klebsiella. Some CRE strains do not respond to any antibiotic.
At risk: Hospital patients using ventilators, urinary catheters or intravenous catheters, those taking long courses of certain antibiotics and those with wounds from injury or surgery.
Symptoms: Depends on the infection. CRE may cause pneumonia, urinary tract infections, bloodstream infections, wound infections and meningitis.
How it spreads: Contact with a wound by an infected person. CRE may also enter the body through contaminated devices, such as catheters.
Methicillin-resistant Staphylococcus aureus (MRSA)
Outside the hospital, this staph germ typically infects the skin. In the hospital, “invasive” MRSA infections, which enter the body through wounds or incisions, can cause bloodstream infections or pneumonia.
At risk: Older adults and people with weakened immune systems; people who have invasive medical tubing (urinary catheters, central lines); those in long-term care.
Symptoms: A MRSA skin infection creates a pustule or boil. Invasive MRSA symptoms vary according to where the bug attacks.
How it spreads: With hospital-borne MRSA, health care workers who neglect to clean their hands – or use contaminated devices – can spread MRSA from patient to patient.
Vancomycin-resistant Enterococci (VRE)
Resists the drug most often prescribed to treat it (vancomycin). Present in the intestines and the female genital tract, where it usually exists without causing illness.
At risk: Surgical patients or others with urinary catheters or central IV lines.
Symptoms: Fever and chills, frequent urination, abdominal pain.
How it spreads: Health care workers with contaminated hands can spread VRE. The germ can also be spread directly to people after they touch contaminated surfaces.