A frightening family of "nightmare" bacteria kills up to its victims, who are often hospital patients infected by health care personnel, and the Centers for Disease Control and Prevention is calling for an urgent response from hospitals and their staffs.
The bacteria, Carbapenem-Resistant Enterobacteriaceae (CRE), kill up to half of patients who get bloodstream infections from them.
"CRE are nightmare bacteria. Our strongest antibiotics don’t work and patients are left with potentially untreatable infections," said CDC Director Tom Frieden, M.D., M.P.H. "Doctors, hospital leaders, and public health must work together now to implement CDC’s "detect and protect" strategy and stop these infections from spreading."
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, according to the CDC's Vital Signs report published today.
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.
According to the report, during the first half of 2012, four percent f hospitals treated a patient with a CRE infection. About 18 percent of long-term acute care facilities treated a patient with a CRE infection during that time.
What to do
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)
- using antibiotics wisely
In addition, CDC recommends screening patients in certain scenarios to determine if they are carrying CRE. Because of the way CRE can be carried by patients from one health care setting to another, facilities are encouraged 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 percent. Several facilities and states in the U.S. have also seen similar reductions.
"We have seen in outbreak after outbreak that when facilities and regions follow CDC’s prevention guidelines, CRE can be controlled and even stopped," said Michael Bell, M.D., acting director of CDC’s Division of Healthcare Quality Promotion. "As trusted health care providers, it is our responsibility to prevent further spread of these deadly bacteria."