More evidence has been revealed that untreatable, antibiotic-resistant infections from a rare but life-threatening superbug are on the rise in U.S. hospitals, creating a growing public health concern, officials said Tuesday.
The findings were published in the CDC’s (Centers for Disease Control and Prevention) Vital Signs report and outline action for the health care community to take immediately on the individual, regional, and national levels.
Early on in 2012, close to 200 hospitals and long-term care facilities treated at least one person infected with these types of bacteria.
The bacteria, Carbapenem-Resistant Enterobacteriaceae (CRE), kill nearly 50 percent of patients who contract bloodstream infections from them.
These bacteria can spread among patients and on the hands of health care workers. CRE bacteria are adaptable; their resistance can mimic those of other bacteria within the same family. This kind of transmission can produce new deadly infections for hospital patients and potentially for normally healthy people.
To date, close to all CRE infections happen in people getting medical care in hospitals, long-term care facilities, or nursing homes.
CDC Director Tom Frieden, M.D., M.P.H. said:
“CRE are nightmare bacteria. Our strongest antibiotics don’t work and patients are left with potentially untreatable infections. Doctors, hospital leaders, and public health, must work together now to implement CDC’s “detect and protect” strategy and stop these infections from spreading.”
Enterobaceriaceae are a family of over 70 bacteria that generally live in the digestive system, such as E.coli and Klebsiella pneumoniae. These bacteria have grown more resistant over time to a group of antibiotics called carbapenems – famously known as “last-resort” antibiotics.
Over the last decade, the CDC has followed one kind of CRE starting at a single health care facility to health care facilities in roughly 42 different states. In several of these places, these bacteria are already threatening a hard-to-treat outbreak for health care professionals.
The CDC report emphasizes the significance of the fact that CRE bacteria are not yet common nationally, however, the percentage of Enterobacteriaceae that are CRE has risen fourfold over the last 10 years.
A resistant form of Klebsiella pneumoniae showed a sevenfold increase in the last decade. In the U.S., states in the Northeast documented the most cases of CRE.
At the start of 2012, four percent of hospitals treated a patient with a CRE infection. During this period, 18 percent of long-term care facilities gave care to a patient with a CRE infection.
The CDC issued a short, practical CRE prevention toolkit in 2012 outlining in-depth guidelines for hospitals, long-term acute care facilities, nursing homes and health departments:
- regulating use of infection control precautions. (standard and contact precautions)
- grouping patients with CRE together.
- reserving rooms, equipment, and staff for the care of patients with CRE when possible.
- communication between facilities when patients with CRE are moved back and forth.
- asking patients if they have received care elsewhere (including other countries).
- using antibiotics wisely.
Additionally, the CDC suggests screening patients with certain conditions to see if they are infected with CRE. Due to the method in which CRE can be carried by patients from one health care setting to another, facilities are recommended to communicate regionally to enforce CRE prevention programs.
These prevention techniques are crucial and can decrease the problem today and in the future. Also, further research is being completed in order to more widely prevent and recognize CRE.
Internationally, CRE seems to be more common, and research reveals that they can be controlled. In an organized effort in Israel across 27 hospitals, CRE rates fell by more than 70 percent. Many hospitals and facilities in the United States have seen similar results.
Michael Bell, M.D., acting director of CDC’s Division of Healthcare Quality Promotion concluded:
“We have seen in outbreak after outbreak that when facilities and regions follow CDC’s prevention guidelines, CRE can be controlled and even stopped. As trusted health care providers, it is our responsibility to prevent further spread of these deadly bacteria.”
Written by Kelly Fitzgerald