by Brianna Crandall — April 18, 2018 — The stakes are higher than ever for thorough cleaning of health-care and other facilities as health departments working with U.S. Centers for Disease Control and Prevention’s (CDC’s) Antibiotic Resistance (AR) Lab Network found more than 220 instances of germs with “unusual” antibiotic resistance genes in the United States last year, according to a new CDC Vital Signs report. This is of special concern to facilities managers (FMs) of healthcare facilities, but important for all FMs to know; facilities cleaning resources are listed below.
Germs with unusual resistance include those that cannot be killed by all or most antibiotics, are uncommon in a geographic area or the US, or have specific genes that allow them to spread their resistance to other germs.
Rapid identification of the new or rare threats is the critical first step in CDC’s containment strategy to stop the spread of antibiotic resistance (AR). When a germ with unusual resistance is detected, facilities can quickly isolate patients and begin aggressive infection control and screening actions to discover, reduce, and stop transmission to others.
According to CDC Principal Deputy Director Anne Schuchat, M.D.:
CDC’s study found several dangerous pathogens, hiding in plain sight, that can cause infections that are difficult or impossible to treat. It’s reassuring to see that state and local experts, using our containment strategy, identified and stopped these resistant bacteria before they had the opportunity to spread.
New strategy stops resistant bugs before they spread widely
The CDC containment strategy calls for rapid identification of resistance, infection control assessments, testing patients without symptoms who may carry and spread the germ, and continued infection control assessments until spread is stopped. The strategy requires a coordinated response among health-care facilities, labs, health departments and CDC through the AR Lab Network. Health departments using the approach have conducted infection control assessments and colonization screenings within 48 hours of finding unusual resistance and have reported no further transmission during follow-up over several weeks.
The strategy complements foundational CDC efforts, including improving antibiotic use and preventing new infections, and builds on existing detection and response infrastructure. New data suggest that the containment strategy can prevent thousands of difficult-to-treat or potentially untreatable infections, including high-priority threats such as Candida auris and carbapenem-resistant Enterobacteriaceae (CRE).
Germs will continuously find ways to resist new and existing antibiotics; stopping new resistance from developing is not currently possible. Recent, nationwide infrastructure investments in laboratories, infection control, and response are enabling tailored, rapid, and aggressive investigations to keep resistance from spreading in health-care settings.
Other study findings showed:
- One in four germ samples sent to the AR Lab Network for testing had special genes that allow them to spread their resistance to other germs.
- Further investigation in facilities with unusual resistance revealed that about one in 10 screening tests, from patients without symptoms, identified a hard-to-treat germ that spreads easily. This means the germ could have spread undetected in that health-care facility.
- For CRE alone, estimates show that the containment strategy would prevent as many as 1,600 new infections in three years in a single state — a 76 percent reduction.
What can FMs do to help?
The CDC provides numerous infection-control resources such as the pages below:
- Environmental Infection Control Guidelines (covering topics such as air-handling systems in health-care facilities; construction, renovation, remediation, repair, and demolition; infection-control and ventilation requirements for various rooms; potential infectious aerosol hazards in health-care facilities; and more)
- Infection Control Basics
- Environmental Cleaning and Disinfecting for MRSA
The American Society of Safety Engineers (ASSE) also offers numerous infection-control articles and resources, such as:
- Avian flu infection control guidelines
- Safety engineers offer flu infection control tips
- American Society of Safety Engineers’ Members Express Concern about MRSA Infections, Recommend Ways to Prevent Infection in the Workplace
- Pandemic Preparation Safety Tips From ASSE
In addition, worldwide cleaning industry association ISSA offers a Cleaning for Infection Prevention site to guide facilities managers (FMs) and cleaning professionals as they work to clean all types of facilities thoroughly for infection control, and especially hospitals and other health-care facilities.
ISSA points out that “Cleaning plays a critical role in protecting human health by preventing transmission of an ever-growing array of harmful, and in some cases, deadly infectious diseases,” and cites the true value of cleaning as “the first line of defense against the spread of infectious agents.”
The page mentions infections recently in the news such as Influenza A, Enterovirus D68, and Ebola, as well as the common cold and flu, and links to applicable cleaning resources and videos.