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CDC Modeling Predicts Growth of Drug-Resistant Infections

Improved infection control and antibiotic prescribing could save 37,000 lives over 5 years, agency says

The latest Vital Signs report from the Centers for Disease Control and Prevention (CDC) includes mathematical modeling that projects increases in drug-resistant infections and in Clostridium difficile without immediate, nationwide improvements in infection control and antibiotic prescribing.

The promising news is that the CDC modeling projects that a coordinated approach — that is, health care facilities and health departments in an area working together — could prevent up to 70% of life-threatening carbapenem-resistant Enterobacteriaceae (CRE) infections over 5 years. Additional estimates show that national infection control and antibiotic stewardship efforts led by federal agencies, health care facilities, and public health departments could prevent 619,000 antibiotic-resistant and C. difficile infections and save 37,000 lives over 5 years.

Antibiotic-resistant bacteria cause more than 2 million illnesses and at least 23,000 deaths each year in the U.S. C. difficile caused nearly half a million illnesses in 2011, and an estimated 15,000 deaths a year are directly attributable to C. difficile infections.

The Vital Signs report recommends the following coordinated, two-part approach to turn these data into action:

  • Public health departments alert health care facilities to drug-resistant germ outbreaks in their area and the threat of germs coming from other facilities.

  • Health care facilities work together and with public health authorities to implement shared infection-control actions to stop the spread of antibiotic-resistant germs and C. difficile between facilities.

The Vital Signs report shows that C. difficile and drug-resistant bacteria — such as CRE, methicillin-resistant Staphylococcus aureus (MRSA), and resistant Pseudomonas aeruginosa — spread inside of and between health care facilities when appropriate infection control actions are not in place and when patients transfer from one health care facility to another for care. These infections can lead to serious health complications, including sepsis or death. Even facilities that follow recommended infection control and antibiotic use practices are at risk when they receive patients who carry these pathogens from other health care facilities.

The report also describes the importance of public health departments taking the lead to:

  • Identify health care facilities in the area and know how they are connected.

  • Dedicate staff to improve connections and coordination with health care facilities in the area.

  • Work with the CDC to use data for action to prevent infections and to improve antibiotic use in health care.

  • Know the antibiotic resistance threats in the area and state. 

    Complementing the public health coordination, the report recommends that hospital owners and health care facility administrators consider steps to:

  • Implement systems to alert receiving facilities when transferring patients who have drug-resistant bacteria.

  • Review and perfect infection control actions in each facility.

  • Make leadership commitments to join area health care-associated infection (HAI)/antibiotic resistance prevention activities.

  • Connect with public health departments to share data about antibiotic resistance and other HAIs.

  • Provide clinical staff access to prompt and accurate laboratory testing for antibiotic-resistant germs.

    The data in the Vital Signs report come from both mathematical modeling and analysis estimates. The CDC used two mathematical simulation models to estimate the impact of the coordinated approach in preventing the spread of antibiotic-resistant germs within a group of health care facilities in an area. Data from the CDC’s National Healthcare Safety Network and Emerging Infections Program informed projections of the number of infections and deaths in the U.S.

    Source: CDC; August 4, 2015.

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