by Brianna Crandall — March 11, 2013—Facilities and custodial professionals charged with sanitation at hospitals and healthcare facilities need to be aware of a family of bacteria that the U.S. Centers for Disease Control and Prevention (CDC) says has become increasingly resistant to even the strongest last-resort antibiotics (carbapenems) during the past decade, causing more hospitalized patients to getting lethal infections that, in some cases, are impossible to cure. CDC has tracked one type of CRE from a single healthcare facility to healthcare facilities in at least 42 states, showing how easily the bacteria can spread.
The findings, published March 5 in the CDC’s Vital Signs report, are a call to action for the entire healthcare community to work urgently—individually, regionally and nationally—to protect patients. 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. Currently, almost all CRE infections occur in people receiving significant medical care in hospitals, long-term acute care facilities, or nursing homes.
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 healthcare 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.
In 2012, CDC released a concise, practical CRE prevention toolkit with in-depth recommendations for hospitals, long-term acute care facilities, nursing homes and health departments. Key recommendations include:
- Enforcing use of infection control precautions (standard and contact precautions);
- Grouping patients with CRE together;
- Dedicating staff, rooms and equipment to the care of patients with CRE, whenever possible;
- Having facilities alert each other when patients with CRE transfer back and forth;
- Asking patients whether they have recently received care somewhere else (including another country); and
- Using antibiotics wisely.
CDC says its core prevention measures are critical and can significantly reduce the problem today and for the future. The agency encourages facilities to work together regionally to implement CRE prevention programs. In some parts of the world, CRE appear to be more common, and evidence shows they can be controlled; Israel recently employed a coordinated effort in its 27 hospitals and dropped CRE rates by more than 70%. Several U.S. facilities and states have reported similar reductions.
