Antibiotic ‘Superbugs’ Have Hospitals on High Alert
The Center for Disease Control (CDC) is ramping up its efforts to prepare hospitals and medical staff for the possibility of encountering and containing rare but lethal “nightmare bacteria,” microbes that have mutated to become resistant to even the most powerful existing antibiotics. These “super-bugs” – difficult or even impossible to treat with the current generation of medicines – typically occur in hospital settings but the major danger is if they are introduced into society as a whole, where they can spread like wildfire, according to the CDC.
In a recent press briefing, the CDC shared that every year, 2 million Americans get infections from antibiotic-resistant bacteria, and 23,000 die from those infections. The CDC’s Antibiotic Resistance Lab network recently tested more than almost 6,000 samples of highly resistant germs from across the U.S. and Puerto Rico over nine months. Of these samples, about one in four had a gene that helps it spread its resistance, and about one in ten could have continued spreading if left undetected. 221 instances contained an especially rare resistance gene. These results prompted the CDC to promote an aggressive containment strategy to stop the spread between people, facilities, and other germs.
The containment strategy encourages health care facilities and public health authorities to quickly identify and respond to even single cases of unusual resistance in patients. This includes assessing and securing the facility when the resistance is found, immediately sending off samples for testing, screening all contacts of the patients (even those without symptoms), coordinating with other facilities, and continuing infection screenings until the spread is fully controlled. While many of these recommendations seem to be common sense, they require a high degree of vigilance and responsiveness. The CDC estimates that if these containment efforts are just 20% effective, they could reduce the number of nightmare bacteria cases by 76% over three years in one area.
Many scientists and health leaders today believe that the over-prescription of antibiotics – or a rise in “incorrect usage” – correlates with the increase in resistant microbes. According to a recent report, the rate of antibiotic consumption increased by almost 40 percent between 2000 and 2015, and the total number of estimated doses taken increased by 65 percent in the same timeframe. Researchers agree that utilizing current science and clinical trails today to prescribe the right drug at the right dose for the right duration and the right infection is imperative to reducing the spread of resistant organisms.
Some hospitals in the U.S. are actively participating in what’s being termed “antimicrobial stewardship,” leveraging guidelines for acute care hospitals released in 2007 by the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America. A 17-year study presented at IDSA’s annual meeting found that such a program implemented in 1993 at Wesley Medical Center in Wichita, Kan., was associated with greater susceptibility of bacteria to antibiotics and a decrease in the amount spent on antibiotics. However, additional IDSA studies show that only one-third of hospitals are fully compliant with the 2007 antimicrobial stewardship guidelines.
By tracking trends in “superbugs” and other antibiotic resistant illnesses, healthcare providers can have a better understanding of how these illnesses of effecting populations.
Tools such as ESO’s EHR and HDE can offer a path for reviewing these types of complications through aggregate level data tracked year-over-year. Providers should look for opportunities to gather data through specialty patient forms and within narratives to highlight cases that appear to antibiotic resistant so better treatment practices can be created.