For so long now, American patients have relied on and demanded antibiotics for every little thing that ails them (and their children). And antibiotic resistance has already been labeled an urgent public health concern.

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But another study this week has found that one family of superbugs in particular, Carbapenem-resistant Enterobacteriaceae (CRE), may be spreading more widely than previously thought.

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Researchers from Harvard T.H. Chan School of Public Health and the Broad Institute of MIT looked at CREs in patients from three Boston hospitals and a hospital in Irvine, California.

They found that not only are these bacteria thriving even when hit with the strongest medicines available, they are also spreading far more than we realize — by person-to-person contact and without symptoms.

“It is not a foregone conclusion that a suitable antibiotic will always be at hand,” said one infectious disease expert.

“You know the phrase ‘Shutting the stable door after the horse has bolted’? The horse has not only bolted, the horse has had a lot of ponies, and they’re eating all our carrots,” Bill Hanage, an infectious diseases epidemiologist at the Harvard T.H. Chan School of Public Health and senior author of the study, told STAT.

CREs, which tend to spread in hospitals and long-term care facilities, cause an estimated 9,300 infections and 600 deaths each year in the United States, said the CDC — and they’re on the rise.

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“There has been a steady march of resistance since the advent of penicillin and we are now at a point where total drug resistance is a reality,” Dr. Amesh Adalja, an infectious disease physician at the University of Pittsburgh Medical Center and an affiliated scholar at the John Hopkins University Center for Health Security, told LifeZette recently.

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Antibiotic-resistant germs make more than two million Americans sick each year in the U.S.; about 23,000 will die from their infections.

Even with extreme precautionary measures, Adalja emphasized it will take using antibiotics appropriately and finding alternatives to antibiotics to solve this problem that now “threatens all of modern medicine.”

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“Antibiotic resistance is a fact of life and infection with one of these strains is a real possibility in certain individuals. The public should realize that the golden age of antibiotics is over, and it is not a foregone conclusion that a suitable antibiotic will always be at hand for infections in the future,” said Adalja.

He added that the threat of antibiotic resistance is not fear-mongering — it is real. However, patients should not delay needed care because of this threat but, instead, should be cognizant of the risk. They should also insist on hand-washing by their providers.