Wednesday, August 05, 2015

CDC’s Vital Signs: A Coordinated Approach To Curb The Spread Of Antibiotic Resistance





Although pandemics and disease outbreaks like MERS and Ebola tend to grab the headlines, there is arguably no greater threat to public health today than the inexorable rise in antibiotic resistant bacteria around the globe.  The CDC estimates that – in the United States alone – at least 23,000 people die each year due to antibiotic resistant infections.


In 2012 - less than 75 years after the first modern antibiotics were rolled out - World Health Director-General Margaret Chan expressed the dire warning that the World Faces A `Post-Antibiotic Era’, one where a minor scrape could prove deadly, and where many elective surgeries would simply be too risky with out prophylactic antibiotics.

We’ve looked at this growing threat dozens of times over the years, but a few highlights include:


WHO: Survey & Analysis On Global Response To Antimicrobial Resistance

CDC: Improving Antibiotic Prescribing Practices In Hospitals

The Lancet: Antibiotic Resistance - The Need For Global Solutions

UK CMO: Antimicrobial Resistance Poses `Catastrophic Threat’

CDC HAN Advisory: Increase In CRE Reports In The United States


While the number and variety of antibiotic resistant organisms continues to grow, among the most dangerous are MRSA, MDR-TB, resistant gonorrhea, NDM-1 (and other NDMs), and a growing list of Carbapenem-resistant Enterobacteriaceae (CREs) like K. pneumoniae.


Much of this medical nightmare has been brought on by the misuse, and over reliance on, antibiotics over the years (see CDC: Improving Antibiotic Prescribing Practices In Hospitals).  And one of the deadly side effects has been the rise in difficult to control  C. difficile infections, which carries with it a high mortality rate.


Yesterday the CDC released a major Vital Signs report that contains modeling showing the likely impact of CRE and C. difficile infections over the next 5 years, under a variety of control scenarios.  While too lengthy to post here, I’ve some excerpts and links for you to explore.


Our first stop is a CDC Press release on the mathematical modeling on the growth of resistant C. dif.


CDC modeling projects growth of drug-resistant infections and C. difficile

Improved infection control and antibiotic prescribing could save 37,000 lives over five years

Embargoed Until: Tuesday, August 4, 2015, 3:30 p.m. ET
Media Relations
(404) 639-3286

The latest CDC Vital Signs includes mathematical modeling that projects increases in drug-resistant infections and Clostridium difficile (C. difficile) without immediate, nationwide improvements in infection control and antibiotic prescribing.

The promising news is that CDC modeling projects that a coordinated approach—that is, health care facilities and health departments in an area working together—could prevent up to 70 percent of life-threatening carbapenem-resistant Enterobacteriaceae (CRE) infections over five years. Additional estimates show that national infection control and antibiotic stewardship efforts led by federal agencies, health care facilities, and public health departments could prevent 619,000 antibiotic-resistant and C. difficile infections and save 37,000 lives over five years.

Antibiotic-resistant germs, those that no longer respond to the drugs designed to kill them, cause more than 2 million illnesses and at least 23,000 deaths each year in the United States. C. difficile caused close to half a million illnesses in 2011, and an estimated 15,000 deaths a year are directly attributable to C. difficile infections.

The report recommends the following coordinated, two-part approach to turn this data into action that prevents illness and saves lives:

  1. Public health departments track and alert health care facilities to drug-resistant germ outbreaks in their area and the threat of germs coming from other facilities, and
  2. Health care facilities work together and with public health authorities to implement shared infection control actions to stop the spread of antibiotic-resistant germs and C. difficile between facilities.

Antibiotic resistant infections in health care settings are a growing threat in the United States, killing thousands and thousands of people each year,” said CDC Director Tom Frieden, M.D., M.P.H. “We can dramatically reduce these infections if health care facilities, nursing homes, and public health departments work together to improve antibiotic use and infection control so patients are protected.”

The Vital Signs report shows that C. difficile and drug-resistant bacteria—like CRE, MRSA (methicillin-resistant Staphylococcus aureus), and resistant Pseudomonas aeruginosa—spread inside of and between health care facilities when appropriate infection control actions are not in place and patients transfer from one health care facility to another for care. These infections can lead to serious health complications, including sepsis or death. Even facilities following recommended infection control and antibiotic use practices are at risk when they receive patients who carry these germs from other health care facilities.

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The full Vital Signs report can be accessed at the link below:


Making Health Care Safer

Stop Spread of Antibiotic Resistance


We're 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 infection control actions can contribute to drug resistance and put patients at risk for deadly diarrhea (caused by C. difficile). Even if one facility is following recommended infection controls, germs can be spread inside of and between health care facilities when patients are transferred from one health care facility to another without appropriate actions to stop spread. Lack of coordination between facilities can put patients at increased risk. Now more than ever is the time for public health authorities and health care facilities to work together, sharing experiences and connecting patient safety efforts happening across the state.


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