Cases of the contagious and deadly “superbug” known as CRE increased five-fold in community hospitals from 2008 to 2012 in the Southeastern U.S., according to a new study.

And while the actual number of patients discovered was low—305—the worry is that CRE infections are under-reported and threaten health care facilities nationwide, said one of the report’s authors. CRE is an antibiotic-resistant bacterium that usually strikes people in hospitals, nursing homes and other health centers.

“This is a wakeup call for hospitals on how to detect the disease,” said Dr. Joshua Thaden, one of the leading authors for the study published in the August issue of the medical journal, Infection Control and Hospital Epidemiology.

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