Drug-resistant bacteria spreading in U.S. health care facilities
Experts say fast action needed to combat it
Drug-resistant germs called carbapenem-resistant Enterobacteriaceae, or CRE, are on the rise and have become more resistant to last-resort antibiotics during the past decade, according to a new Centers for Disease Control and Prevention (CDC) Vital Signs report. These bacteria are causing more hospitalized patients to get infections that, in some cases, are impossible to treat.
The findings, published in the CDC’s Vital Signs report, are “a call to action for the entire health care community to work urgently – individually, regionally and nationally – to protect patients,” according to a statement released by the CDC.
During just the first half of 2012, almost 200 hospitals and long-term acute care facilities treated at least one patient infected with these bacteria.
The bacteria, Carbapenem-Resistant Enterobacteriaceae (CRE), kill up to half of patients who get bloodstream infections from them. In addition to spreading among patients, often on the hands of health care personnel, CRE bacteria can transfer their resistance to other bacteria within their family. This type of spread can create additional life-threatening infections for patients in hospitals and potentially for otherwise healthy people. Currently, almost all CRE infections occur in people receiving significant medical care in hospitals, long-term acute care facilities, or nursing homes.
The CDC says CRE pose a triple threat:
- Resistance: CRE are resistant to all, or nearly all, the antibiotics available - even the most powerful drugs of last-resort.
- Death: CRE have high mortality rates – CRE germs kill 1 in 2 patients who get bloodstream infections from them.
- Spread of disease: CRE easily transfer their antibiotic resistance to other bacteria. For example, carbapenem-resistant klebsiella can spread its drug-destroying weapons to a normal E. coli bacteria, which makes the E.coli resistant to antibiotics also. That could create a nightmare scenario since E. coli is the most common cause of urinary tract infections in healthy people.
CRE are usually transmitted from person-to-person, often on the hands of health care workers. In 2012, CDC released a concise, practical CRE prevention toolkit with in-depth recommendations to control CRE transmission in hospitals, long-term acute care facilities, and nursing homes. Recommendations for health departments are also included. CRE can be carried by patients from one health care setting to another, so facilities are encouraged to work together, using a regional “Detect and Protect” approach, to implement CRE prevention programs.
In addition to detailed data about the rise of CRE, the Vital Signs report details steps health care providers, CEOs and chief medical officers, state health departments and patients can take now to slow, and even stop, CRE before it becomes widespread throughout the country.
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