Coordinated efforts can stem spread of drug-resistant infections and illnesses in nation’s healthcare centers

Improved infection control and prescribing of antibiotics could save 37,000 lives over five years

August 04, 2015

Susan Huang, MD, MPH

Increases in drug-resistant infections and Clostridium difficile illnesses are projected to occur in the nation’s healthcare facilities without immediate, nationwide improvements in infection control and antibiotic prescribing, according to a Centers for Disease Control and Prevention mathematical modeling report co-authored by a UC Irvine Health infectious diseases specialist.

Dr. Susan Huang, professor of medicine and medical director of epidemiology and infection prevention for UC Irvine Health, said the promising news is that CDC modeling also projects that a coordinated approach — that is, healthcare facilities and health departments in an area working together — could prevent the majority of life-threatening carbapenem-resistant Enterobacteriaceae (CRE) cases within 15 years.

Additional estimates show that national infection control and antibiotic stewardship efforts led by federal agencies, healthcare facilities, and public health departments could prevent 619,000 antibiotic-resistant and C. difficile infections and save 37,000 lives over five years.

“When it comes to contagious pathogens, no healthcare facility is an island,” Huang said. “Hospitals and nursing homes in the same region should join forces to stop the spread of these pathogens. By investing in joint strategies, we can protect our patients and community from antibiotic-resistant bacteria.”

The CDC modeling was based, in part, on long-standing research she and healthcare colleagues conducted at Orange County hospitals, nursing homes and skilled nursing facilities. With these groups and the Orange County Health Care Agency, she continues to assess and address the burden of multi-drug resistant pathogens, and has demonstrated in multiple simulation models (in collaboration with Dr. Bruce Lee at Johns Hopkins University) the importance of inter-facility patient sharing as a driver of spread.

Her ongoing interest is to strengthen these regional collaborations to address antibiotic-resistant organisms, and she is currently seeking federal grants to conduct regional interventions to address this problem.

The study appears in the latest issue of CDC Vital Signs.

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Antibiotic-resistant germs are those that no longer respond to the drugs designed to kill them and cause more than 2 million illnesses and at least 23,000 deaths each year in the U.S. C. difficile caused close to half a million illnesses in 2011, and an estimated 15,000 deaths a year are directly attributable to C. difficile infections, which causes severe diarrhea.

The report recommends a coordinated, two-part approach to turn this data into action that prevents illness and saves lives:

  1. Public health departments track and alert healthcare facilities to drug-resistant germs outbreaks in their area and the threat of germs coming from other facilities, and health care facilities work together and with public health authorities to implement shared infection control actions to stop the spread of antibiotic-resistant germs and C. difficile between facilities.

“Antibiotic resistant infections in healthcare settings are a growing threat in the U.S., killing tens of thousands of people each year,” said CDC Director Tom Frieden, MD, MPH. “New CDC modeling show that we can dramatically reduce these infections if healthcare facilities, nursing homes, and public health departments work together to improve antibiotic use and infection control so patients are protected.”

The Vital Signs report shows that C. difficile and drug-resistant bacteria — such as CRE, MRSA (methicillin-resistant Staphylococcus aureus), and resistant Pseudomonas aeruginosa — spread inside of and between healthcare facilities when appropriate infection control actions are not in place and patients transfer from one healthcare facility to another for care. These infections can lead to serious health complications, including sepsis or death. Even facilities following recommended infection control and antibiotic use practices are at risk when they receive patients who carry these germs from other healthcare facilities.

Clinical investigators from the CDC, University of Utah, Johns Hopkins, the University of Pittsburgh and Harbor-UCLA Medical Centers also contributed to the report.

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