Providers must act to prevent the spread of antibiotic-resistant bacteria killing about half of all people who become infected, the Centers for Disease Control & Prevention said in March.

Carbapenem-Resistant Enterobacteriaceae (CRE) is found in healthy digestive systems but causes infections when it gets in other organs or the bloodstream. Some CRE germs are resistant even to antibiotics of “last resort,” such as carbapenems, and the germs can transfer their resistance to other kinds of bacteria. 

A CDC official said the disease could mean “the beginning of the end of antibiotics.” The agency is offering a CRE toolkit with prevention guidelines for nursing homes. These include recommendations on contact precautions and discouragement of devices such as urinary catheters. 

About 18% of long-term acute care facilities saw a CRE infection in the first half of 2012, but hospital patients and nursing home residents also have become infected. CRE infections have been reported by 42 states and are often seen in the Northeast, the agency said.