Combating deadly antibiotic-resistant infections: CDC says teamwork is key

Superbugs – or deadly bacteria that can’t be killed, even with standard antibiotics – infect more than two million Americans and cause at least 23,000 deaths every year. But a new report from the Centers for Disease Control and Prevention (CDC) suggests the U.S. could save 37,000 lives over the next five years through refocused efforts.

According to the report, the U.S. is at a tipping point: an increasing number of germs no longer respond to the drugs designed to kill them. Inappropriate prescribing of antibiotics and lack of proper infection prevention and control measures can contribute to drug resistance and put patients at risk for deadly infection.

The report calls for a coordinated approach, in which health facilities in a region share data with a central public health authority that disseminates information to area facilities. Essentially, such coordination would alert receiving facilities when transferring patients who have drug-resistant germs so that the receiving facility can use appropriate antibiotics and implement adequate infection control actions to better-protect patients.

While individual hospitals already take actions to control infections, such as washing hands and wearing disposable gowns, these actions aren’t enough.

“Even if one facility is following recommended infection control measures, germs can be spread between health care facilities – from nursing home to hospital, or hospital to hospital,” said Chetan Jinadatha, M.D., M.P.H., assistant professor at the Texas A&M Health Science Center College of Medicine and chief of infectious diseases at the Central Texas Veterans Health Care System in Temple. “If there are no proper communications channels in place, superbugs can easily run rampant.”

And run rampant they will. Based on the CDC’s analysis, the number of infections caused by four of the most dangerous bacteria – CRE, multidrug-resistant Psuedomonas aeruginosa, invasive methicillin-resistant Staphylococcus aureus (MRSA) and C. difficile – is likely to increase 10 percent over the next five years, climbing from 310,000 in 2011 to an estimated 340,000 per year. According to the report, with immediate implementation of nationwide interventions, medical facilities could prevent more than half a million hospital-acquired infections over the same five-year period. They also estimate the approach would save the health care system $7.7 billion in treatment costs.

The CDC looked at one nightmare bacteria, in particular, CRE – a group of antibiotic-resistant bacteria that usually strike people in hospitals, nursing homes and other health care settings – and found infection rates of CRE could be drastically cut with coordinated efforts. In fact, in a simulated introduction of CRE into 10 health care facilities, they found that CRE spread to 12.2 percent of patients after five years; and if facilities made individual efforts, the cases fell to about 8.6 percent. When facilities coordinated extensively, prevalence was reduced to only 2.1 percent of the population after five years.

“When facilities worked together, through a centralized public health agency, the facilities were able to take faster action to curb the deadly bacterium’s spread,” Jinadatha noted.

But it’s not just about hospital infection control measures.

The superbug issue also stems from overprescribing of antibiotics, drugs designed to kill bacteria. According to the CDC, up to 50 percent of all antibiotic prescriptions are unnecessary.

“When physicians overprescribe or incorrectly use them to treat viruses, bacteria can become resistant to antibiotics,” Jinadatha noted. “As a result, superbugs simply can’t be controlled with antibiotics. It’s a deadly combination.”

The CDC report recommends physicians practice “antimicrobial stewardship.”

“Antibiotic stewardship is essentially being a good steward of antibiotics – using the right kind of antibiotics, in the right dosage, for the right reasons,” Jinadatha said.

According to the CDC, support from Congress is needed to implement such plans.

“Antibiotic resistance is a public health problem,” Jinadatha said. “Fighting superbug infections is possible, but we must all work together to protect patients and thus save tens of thousands of lives.”