Healthcare coordination could fight 'superbug' infections in US

7 August 2015

The number of patients infected by hospital-acquired infections such as antibiotic-resistant e.coli could be more than halved with better coordination and cooperation between healthcare facilities, argues the Center for Disease Control and Prevention (CDC).

Two mathematical modelling experiments compared the number of infections due to carbapenem-resistant Enterobacteriaceae (CRE) - a family of germs that includes antibiotic-resistant e.coli and the klebsiella species - when healthcare facilities act independently to enhance infection controls and when they work together in a coordinated response. 

The first model, based on a ten facility network, showed that CRE infections could be reduced by up to 70% over five years with a coordinated rather than independent approach. The second model, based on a 102 facility network, resulted in a 55% reduction of CRE infections over fifteen years.

Antibiotic-resistant infections are a growing threat causing at least two million illnesses and at least 23,000 deaths each year in the US, according to the CDC. Furthermore, the CDC estimates that infections caused by the most problematic antibiotic resistant strains of bacteria ‘superbugs’ will rise by 10% over the next five years. Superbugs are usually acquired in hospitals from contaminated surfaces, catheters and ventilators. Outbreaks can move between facilities with the movement of patients. 

The CDC argues that coordination and communication among healthcare facilities, nursing homes and public health departments could reduce infections being transported from one place to another. 

Senior co-author, Matthew H. Samore of University of Utah said: "The actual effectiveness of any intervention is going to depend on a number of factors. But the modelling shows that communication and sharing of information among facilities is much more effective than the standard approach of hospitals and nursing facilities acting independently to stop spread of resistant bacteria".

In order to turn the data into action that prevents illness and saves lives the authors of the report urged public health departments to track and alert healthcare facilities of antibiotic-resistant bacteria outbreaks in their area and other facilities. They call for coordination in the development of shared infection controls to stop the spread of antibiotic-resistant bacteria between facilities.

Looking ahead, CDC Director Dr Tom Frieden called for investment to make the interventions happen. 

“Without those investments, we’ll continue to struggle, and patients will continue to get infections that could have been prevented…It’s up to Congress to support the resources needed to protect Americans.”

In Pathogen Genomics Into Practice, the PHG Foundation argues for similar efforts when building genomics infrastructure to combat infectious disease.   

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