CDC microbiologist holds modified Hodge test, used to identify resistance in bacteria known as Enterobacteriaceae. Bacteria that are resistant to carbapenems, considered “last resort” antibiotics, produce a distinctive clover-leaf shape.
A new study of the prevalence carbapenem-resistant enterobacteriaceae in 16 Washington, D.C. hospitals claims the dangerous, drug-resistant superbug is very present in area hospitals and healthcare facilities.
The study, published by the District of Columbia Hospital Association, looked at data from January through April. It showed that out of 1021 completed patient tests, 52 tested positive for CRE, a prevalence rate of 5.1 percent. Acute care facilities showed a slightly lower rate, while sub-acute facilities like skilled nursing came in higher at 5.7 percent.
A point of real concern is that many of these patients are what's called 'silent carriers', meaning CRE is present in their bodies but they are not showing signs of illness, which creates the possibility of easy and unidentified spreading to other patients, staff and facilities, the DCHA said.
DCHA chief operating officer Jo Ann Nelson, MD, said that in August 2015, the CDC issued a national call to action asking health systems to devise coordinated regional approaches to learning more about and dealing with CRE, which is a subset of a broader group of multidrug resistant organisms. CRE is highly dangerous because it carries a high mortality rate when contracted. Carbapenem refers to the group of antibiotics that the bacteria is resistant to.
Nelson said the results of their study weren't a surprise, but they provided a necessary jumping off point to start planning how to combat the problematic bacteria.
"They weren't shocking in any way. We knew the organisms were there. We didn't know at what level. Everybody was kind of like now we can get to work. We can really dive into the data, look at what's there, and begin to develop strategies for how we manage this going forward."
The DCHA study took more than a year to orchestrate and was already in the planning stages when the CDC issued their August request. The Association managed to pull together D.C. health facilities including George Washington University Hospital, Children's National Medical Center, BridgePoint Hadley Skilled Nursing Facility, MedStar Rehabilitation Network and more. She said the level of cooperation and participation with the study shows the level of urgency to the CRE threat and a desire on the part of hospitals to work together on solutions.
"If you know something and don't do anything with it, it's not of any value. So the goal is definitely to take it and build on it," Nelson said.
According to the CDC, CRE causes 9,000 drug-resistant infections a year, and 600 deaths. More broadly, at least 2 million people nationwide are infected with antibiotic-resistant bacteria, leading to 23,000 deaths overall.