The rate of drug-resistant E. coli infections seen in community hospitals doubled between 2009 and 2014, with the majority of the infections occurring in healthcare settings, a study by Duke Medicine found.
But researchers also found that infection rate among patients with limited exposure to healthcare facilities more than tripled, suggesting further study is needed into community-acquired infections.
The findings are important because more than half of U.S. patients receive their healthcare from community hospitals, according to a Duke University announcement.
"We have always considered antibiotic-resistant organisms a problem at large hospitals," Deverick Anderson, M.D., an infectious disease specialist at Duke University School of Medicine and senior author of the study, said in the announcement. "This study goes a long way in demonstrating that the problems with antibiotic-resistant organisms occur in all healthcare settings, not just large ones."
In reviewing patient records at 26 hospitals in the Southeast, Duke researchers found that the incidence of drug-resistant extended-spectrum beta-lactamase (ESBL)-producing E. coli doubled from 5.28 incidents per 100,000 patients to 10.5 infections per 100,000 during the study period. The median age of infected patients was 72.
Lead author Joshua Thaden, M.D., a fellow in Duke's Division of Infectious Diseases, suggested it may be time to actively screen patients for antibiotic-resistant E. coli. Patients may not exhibit symptoms even if their skin is colonized with the bacteria, he said in the announcement.
The findings are published online in Infection Control & Hospital Epidemiology, and come amid fears of a looming global crisis of antibiotic-resistant superbugs brought on by overuse and misuse of antibiotics. The only sustainable solution is to rein in antibiotic use, said the co-author of the report, "The State of the World's Antibiotics, 2015." Improving water, sanitation and immunization will reduce the need for antibiotics, according to the report, as will better hospital infection control and implementation of antibiotic stewardship programs.
Some hospitals are experimenting with using naturally germ-resistant copper surfaces to reduce the risk of spreading dangerous microbes, FierceHealthcare previously reported. High-touch, easily contaminated areas being replaced with copper include faucet and cabinet handles, IV poles and nurse call buttons.