A simulation of how the CRE superbug might spread among healthcare facilities found that coordinated efforts prevented over 75% of infections that would have otherwise occurred over a 5-year period, according to a study published in the American Journal of Epidemiology.
What’s the problem?
April 13, 2016 – The CRE superbug is an antibiotic-resistant bacterium most often found in long-term healthcare facilities. Infections are difficult if not impossible to treat, and the bacteria kill up to half of those infected, according to the Centers for Disease Control and Prevention (CDC). Hospital and nursing home patients are typically more susceptible to superbugs due to the increased rate of exposure among vulnerable patients, many of whom transfer between facilities while infected. CDC considers superbugs a serious public health threat, and has issued a “tool kit” to help healthcare facilities design plans to curb their transmission.
For the new study, researchers at Johns Hopkins Bloomberg School of Public Health in Baltimore simulated how CRE would likely spread across facilities in Orange County, CA, under 3 scenarios:
- The 1st included no interventions.
- The 2nd involved interventions at individual healthcare facilities, including testing incoming patients for CRE infection. For patients who test positive, contact precautions such as gloves and gowns are implemented.
- The 3rd scenario used the above 2 interventions, with the addition of coordinating efforts among facilities when CRE infection cases reach a certain number.
The researchers determined that a coordinated approach prevented 2,789 (77%) total infections by the 5th year, while moderate control measures prevented 408 transmissions (21.3%) after 5 years. Adding no new infection-control measures in the event of a CRE superbug outbreak (scenario 1) would result in CRE bacteria being present in nearly all Orange County facilities within 10 years, according to the study.
“It’s like a neighborhood watch program where neighbors work with and watch out for each other,” said Bruce Y. Lee, MD, MBA, associate professor in the Bloomberg School’s Department of International Health. “This approach tends to be more effective than a homeowner doing it alone. When it comes to health care facilities and superbugs, the same principles of communication and coordination apply.”
While there has not yet been a severe CRE superbug outbreak in 2016, within the first 6 months of 2012, 3.9% of acute care hospitals and 17.8% of long-term acute care hospitals reported at least 1 infection. Additionally, the bacteria has been confirmed in at least 48 states.
The primary threat of superbugs like CRE is that they are antibiotic-resistant; the bacteria are currently responsible for approximately 2 million illnesses and 23,000 deaths annually in the U.S., according to CDC. There is growing concern that without inter-facility coordination — including the development of patient information sharing protocols — an outbreak could spread rapidly in light of patient transfers and mobility.