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CDC: Immediate Action Needed to Halt Spread of Deadly Bacteria

More inpatients infected with carbapenem-resistant bugs (Mar. 5)

A family of bacteria has become increasingly resistant to last-resort antibiotics during the past decade, and more hospitalized patients are getting potentially lethal infections that, in some cases, are impossible to cure. According to the Centers for Disease Control and Prevention (CDC), the new findings — published in the agency’s Vital Signs report — are a call to action for the entire health care community to work urgently to protect patients. During 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 develop CRE-related bloodstream infections. 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, the CDC says. 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 patients receiving significant medical care in hospitals, in long-term acute care facilities, or in nursing homes.

“CRE are nightmare bacteria. Our strongest antibiotics don’t work, and patients are left with potentially untreatable infections,” said CDC Director Tom Frieden, MD, MPH. “Doctors, hospital leaders, and public health must work together now to implement CDC’s ‘detect and protect’ strategy and stop these infections from spreading.”

Enterobacteriaceae are a family of more than 70 bacteria, including Klebsiella pneumoniae and Escherichia coli, that normally live in the digestive system. Over time, some of these bacteria have become resistant to carbapenem antibiotics. During the past decade, the CDC has tracked one type of CRE from a single health care facility to health care facilities in at least 42 states. In some medical facilities, these bacteria already pose a routine challenge to health care professionals, the agency says.

The Vital Signs report states that, although CRE bacteria are not yet common nationally, the percentage of Enterobacteriaceae that are CRE increased by fourfold during the past decade. One type of CRE — a resistant form of K. pneumoniae — has shown a sevenfold increase during the past 10 years. Most cases of CRE infection are reported in the northeastern U.S.

According to the report, during the first half of 2012, 4% of hospitals and 18% of long-term acute care facilities treated a patient with a CRE infection.

In 2012, the CDC issued a CRE prevention toolkit with recommendations for hospitals, long-term acute care facilities, nursing homes, and health departments.

In addition, the agency recommends screening patients in certain scenarios to determine whether they are infected with CRE. Because CRE can be carried by patients from one health care setting to another, the CDC encourages facilities to work together regionally to implement CRE prevention programs.

Source: CDC; March 5, 2013.

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