CRE part of a greater public health crisis

By Leslie Small

While the scope-linked outbreaks illustrate the dangers of one particular superbug, carbapenem-resistant Enterobacteriaceae (CRE) is just one among many types of antibiotic-resistant bacteria that have increasingly worried world governments.

A December report from the British government warned that antimicrobial-resistant infections kill about 70,000 people worldwide every year, predicting that failure to fight the threat could cause 10 million deaths a year globally and cost $100 trillion per year by 2050. Speaking at the annual American Hospital Association conference in May, Centers for Disease Control and Prevention (CDC) Director Thomas Frieden echoed that warning, noting that an aggressive intervention program could prevent half a million drug-resistant infections in the next five years.

To that end, the White House has earmarked $1.2 billion to help the CDC and other agencies in a broad-based effort to cut Clostridium difficile infections by 50 percent, Methicillin-resistant Staphylococcus aureus rates by at least half; hospital-acquired multidrug resistant Psuedomonas species infections by 35 percent; and CRE infections by 60 percent.

While the fight against superbugs will require help from a variety of stakeholders, hospitals play a particularly important role, Arjun Srinivasan, M.D., pictured right, the CDC's associate director for healthcare-associated infection programs, told FierceHealthcare in an exclusive interview.

"We obviously encourage hospitals to take very concrete steps when it comes to preventing infections from occurring and improving the use of antibiotics," he said, adding that the latter "turns [antibiotic resistance] off at the source, if you will."

Those concrete steps are two-fold: First, the CDC asks hospitals to closely monitor the frequency and type of antibiotic-resistant infections that occur among its patients; and second, it encourages hospitals to report this data into the government's Healthcare Safety Network so the CDC can study larger patterns.

The federal government requires hospitals to report certain hospital-acquired infections in order to receive Medicare and Medicaid reimbursement, and a "growing number of states" require that hospitals report antibiotic-resistant infections such as CRE, he said.

However, "even more important than reporting that data into the system is using that data. So it's looking at that data and using it to figure out where you might have problems and where you need to be focusing your prevention efforts," Srinivasan said. For instance, a recent study revealed that C. diff cases among hospitalized patients are highest in the Northeast region of the U.S. and in the springtime.

Regardless of what type of infections a hospital struggles with or what steps it takes to mitigate these risks, there are few more important efforts for healthcare providers to undertake, Mark Duro director of sterile processing operations at New England Baptist Hospital in Boston, told FierceHealthcare.

"People go to hospitals because they're sick, and they go there to get better, not to get worse," he said. "Infection prevention is as close to the heart of the hospital as you can get."


CRE part of a greater public health crisis