USA needs to take immediate steps to fight super bugs, experts say

The USA could save 37,000 lives over the next five years by taking immediate action to improve the way it fights health care-associated infections, according to a new report from the Centers for Disease Control and Prevention.

Infections with super bugs – bacteria that can’t be killed even with standard antibiotics – cause more than 2 million illnesses and at least 23,000 deaths a year, according to the CDC. These bacteria can spread when people overuse antibiotics. Super bugs often spread in the hospital, especially among patients with weakened immune systems.

In addition, an additional 250,000 patients are treated in hospitals every year for a bacteria called C. difficile, which can spread easily in hospitals and flourish in patients who’ve been treated with antibiotics, which can wipe out the healthy bacteria normally found in the gut, allowing dangerous bugs to take over. C. difficile kills 15,000 Americans a year.

These bugs are among the "leading threats we face in this country," said CDC director Thomas Frieden.

Based on current trends, the number of infections caused by four of the most dangerous bacteria is likely to increase 10% over the next five years. By taking immediate action, however, the country could prevent an estimated 619,000 health care-associated infections over that time, as well as save $7.7 billion, according to the CDC’s mathematical model.

“Antibiotic resistance is a public health crisis,” said Amanda Jezek, vice president of public policy and government relations for the Infectious Diseases Society of America, who wasn’t involved in the new report. “If we don’t take some comprehensive, coordinated action very soon, this crisis will continue to grow and impact more people and claim more lives.”

Hospitals already take steps to control infections, such as telling staff to wash their hands frequently and wear disposable gowns when treating infected patients.

But these steps aren’t enough.

“Even if a hospital is following recommended infection-control practices, that doesn’t protect them from bringing in resistant germs from other facilities, including nurse homes,” said John Jernigan, director of the CDC’s Office of Health Associated Infections Prevention Research and Evaluation.

According to the CDC model, introducing a "nightmare" bacteria called CRE, or carbapenem-resistant Enterobacteriaceae, into a group of 10 regional hospitals today would lead to 2,131 of patients affected over five years. If hospitals act individually to fight the outbreak, the number of affected patients drops to 1,590. Coordinating efforts across a region could reduce the number of affected patients to 406, according to the CDC.

“Because we work in a bigger world where people may visit many hospitals, we all need to work together,” said Jesse Jacob, an assistant professor at Emory University and the Emory Antibiotic Resistance Center in Atlanta.

Hospitals could take several steps to reduce the spread of infections, Jacob said. For example, health care facilities in a region could work together to create a standard transfer form, used whenever patients move between facilities. That could allow doctors to easily check whether patients have been exposed to resistant bacteria.

But coordinating efforts across a region isn’t easy, said LaMar Hasbrouck, executive director of the National Association of County and City Health Officials. Hospitals and nursing homes that aren’t affiliated with one another may not be able to easily share electronic health records, for example. That can make it more difficult to flag an infected patient who’s transferred from one facility to another.

In Illinois, where Hasbrouck was until recently the director of the Department of Public Health, health officials created a registry of CRE patients. Doctors could use the registry to see if patients had ever been affected by CRE, Hasbrouck said.

Giving hospitals incentives to measure and report their rates of hospital-acquired infections would help, Hasbrouck said. For example, states could require hospitals to report this data in order to be licensed. “Hospitals need to know they’re going to be rated on this,” Hasbrouck said.

Doctors and patients need to use antibiotics more judiciously, said Sara Cosgrove, associate professor of medicine and epidemiology at Johns Hopkins University in Baltimore and a spokeswoman for the Society for Healthcare Epidemiology of America. According to the CDC, 20% to 50% of all antibiotic prescriptions are either unnecessary or inappropriate.

President Obama’s proposed budget for fiscal year 2016 nearly doubled the amount of federal funding for combatting and preventing super bugs, to more than $1.2 billion.