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Drug-Resistant CRE Infections Are On The Rise…And 48% Fatal

Posted on July 24 2014

A new study, which is published in the August issue of the journal Infection Control and Hospital Epidemiology, made an alarming revelation. Over the last five years, the Southeastern United States has seen a five-fold increase in the number of infections caused by the drug-resistant superbug known as CRE (a type of bacteria called carbapenem-resistant enterobacteriaceae).

 

CRE is an extremely contagious type of bacteria that is easily transmitted from one person to another, and it is highly resistant to the most commonly-used antibiotics. In addition to causing infections in the urinary tract, lungs, blood, and other areas, CRE also has a high fatality rate of at least 48%; labeling it as “one of the three greatest threats to human health” by the World Health Organization.

 

According to the study findings, just about all of the 305 confirmed cases of CRE infections were healthcare-related. The increased rate of transmission for CRE infections can be attributed to the:

-- recent increase and overuse of broad-spectrum antibiotics,

-- ease of which CRE enzymes could be transmitted among bacteria; and

-- increased transmission between long-term acute care facilities and community hospitals.

 

According to the CDC, diligently adhering to the following 8 practices can help prevent/reduce the transmission of CRE infections:

 

1 – Proper Hand Washing

Make sure there is an adequate amount of hand washing stations and that they are well stocked with supplies like hand soaps, paper towels, and instant hand sanitizers. Monitoring the staff’s hand hygiene practices and pointing out missed opportunities can also help.

 

2 – Contact Precautions

Patients with CRE infections or colonization should be placed under contact precautions. Remember that all staff and visitors should clean their hands before putting on isolation gowns and gloves (which should be put on before entering the patient’s room) and they also remove the gown and gloves and wash their hands again when leaving the affected patient’s room.

 

3 – Healthcare Personnel Education

All employees who work with and around patients with contagious infections, including CRE, should be well informed on the proper use of contact precautions and hand hygiene.

 

4 – Limiting the Use of Devices

Using devices (like central venous catheters, endotracheal tubes, and urinary catheters) increases a patients risk for device-associated infections, including CRE. Therefore, device use should be limited and only used for as long as medically necessary.

 

5 – Patient and Staff Cohorting

Whenever possible, patients with highly infectious diseases (including CRE) should be put in single patient rooms or roomed with another patient with the same infection. It is also a good idea to dedicate certain staff to treating these patients, which helps ensure that the staff is aware of their infection and how to protect themselves.

 

6 – Laboratory Notification

Laboratories should have a specific set of protocols in place to ensure that the correct staff members/departments are notified in a timely manner anytime CRE infections have been identified.

 

7 – Antimicrobial Stewardship

Antimicrobial stewardship programs should be tailored towards minimizing the transmission of multi-drug resistant organisms. Antimicrobials should only be used when necessary and for the shortest duration as possible to still be effective.

 

8 – CRE Screening

CRE screening is one of the primary prevention strategies for all types of healthcare facilities. Point prevalence surveys and the screening of epidemiologically linked patients are two highly effective strategies.

 

This study highlights the importance of taking steps to improve CRE prevention and control efforts. As Joshua Thaden, MD, the lead author of the study, explains, “A CRE epidemic is fast approaching. We must take immediate and significant action in order to limit the transmission of these dangerous pathogens throughout our hospitals and acute care facilities.”

 

Mountainside Medical Equipment offers a comprehensive selection of supplies for helping prevent the spread of infections. Browse through our selection of cleaning and disinfecting supplies, personal protection/isolation gear, and bodily fluid spill cleanup kits.

Sources:

http://www.cdc.gov/hai/organisms/cre/cre-toolkit/f-level-prevention.html

http://www.shea-online.org/View/ArticleId/298/Cases-of-Drug-Resistant-Superbug-Significantly-Rise-in-Southeastern-U-S.aspx

http://www.tomballregionalmedicalcenter.com/tomball-regional-medical-center/health-library/drugresistant-superbug-increasing-in-southeast-us-36088.aspx

 

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