In the United States, about 2 million people become ill each year with antibiotic-resistant (AR) infections -- and of these, about 23,000 patients die.
U.S. medical facilities and staff have made progress in the prevention of health care-associated infections (HAIs), but there still is room for improvement, including in the fight against AR bacteria.
This is according to a recent CDC Vital Signs(www.cdc.gov) report and related Morbidity and Mortality Weekly Report(www.cdc.gov) that urged health care professionals to use a combination of infection-control tactics to better protect patients from these infections.
"New data show that far too many patients are getting infected with dangerous, drug-resistant bacteria in health care settings," said CDC Director Tom Frieden, M.D., M.P.H., in a news release.(www.cdc.gov) "Doctors and health care facilities have the power to protect patients -- no one should get sick while trying to get well."
- A recent CDC Vital Signs report and related Morbidity and Mortality Weekly Report addressed control of health care-associated infections (HAIs) and antibiotic-resistant infections.
- National data signaled achievements including a 50 percent decrease in central line-associated bloodstream infections between 2008 and 2014.
- The CDC’s annual progress report on HAI prevention showed that hospital-onset Clostridium difficile infections decreased 8 percent between 2011 and 2014.
In short-term acute care hospitals, one in seven catheter- and surgery-related HAIs is caused by any of six AR bacteria. This increases to one in four infections in long-term acute care hospitals.
The six AR threats the reports examined are:
- carbapenem-resistant Enterobacteriaceae,
- methicillin-resistant Staphylococcus aureus,
- extended-spectrum β-lactamase-producing Enterobacteriaceae,
- vancomycin-resistant Enterococcus,
- multidrug-resistant Pseudomonas aeruginosa and
- multidrug-resistant Acinetobacter.
Hospitals Improve HAI Prevention
National data from 2014 reported in this Vital Signs issue and from the CDC's latest annual progress report on HAI prevention,(www.cdc.gov) also published this year, signaled promising achievements such as a 50 percent decrease in central line-associated bloodstream infections between 2008 and 2014, and a 17 percent decrease in surgical site infections between 2008 and 2014 related to 10 procedures tracked in previous HAI progress reports.
The Vital Signs report also examined the role of Clostridium difficile, which was recently recognized as the most common type of bacteria responsible for infections in acute care hospitals. In 2011, the bacteria caused 453,000 infections with 29,000 patients dying within 30 days of diagnosis.
The good news is the CDC’s annual progress report showed that progress has been made by decreasing hospital-onset C. difficile infections by 8 percent between 2011 and 2014.
CDC Calls Health Care Professionals to Action
The CDC is calling on physicians, nurses, health care facility administrators, and state and local health departments to be vigilant in preventing HAIs.
"For clinicians, prevention means isolating patients when necessary," said Clifford McDonald, M.D., associate director for science at the CDC’s Division of Healthcare Quality Promotion, in the news release. "It also means being aware of antibiotic resistance patterns in your facilities, following recommendations for preventing infections that can occur after surgery or from central lines and catheters placed in the body, and prescribing antibiotics correctly."
The Vital Signs report recommended physicians start antibiotics promptly and then reassess patients 24-48 hours later. Also, physicians should be prepared to stop antibiotic treatment when appropriate.
New Patient Resource Tracks HAI, Antibiotic-resistant Bacteria
Along with its annual progress report on health care-associated infection prevention, the CDC released the Antibiotic Resistance Patient Safety Atlas,(www.cdc.gov) a new Web app with interactive data on health care-associated infections caused by antibiotic-resistant bacteria.
The tool provides national, regional and state map views of superbug/drug combinations showing percent resistance over time that can be filtered by time period, event type and patient age.
The Atlas uses data reported to the CDC’s National Healthcare Safety Network from 2011 to 2014 from more than 4,400 health care facilities.
Government Agencies Support This Fight
The CDC, CMS and the Agency for Healthcare Research and Quality, along with state mandates for public reporting of HAIs, have all contributed to progress in improving transparency, accountability and quality when it comes to better patient safety against HAIs and AR infections.
"The good news is that we are preventing health care-acquired infections, which has saved thousands of lives," said Patrick Conway, M.D., CMS deputy administrator and chief medical officer, in the news release. "The challenge ahead is how we help to prevent antibiotic resistance as well as infections. We are using incentives, changes in care delivery and transparency to improve safety and quality for patients."
Congress also has responded, appropriating $160 million in new funding in fiscal year 2016 for the CDC to implement the National Action Plan for Combating Antibiotic-resistant Bacteria.(www.whitehouse.gov)
With this funding, the CDC will fight the spread of antibiotic resistance by
- accelerating outbreak detection and prevention in every state,
- enhancing tracking of resistance mechanisms and resistant infections,
- supporting innovative research to address current gaps in knowledge and
- improving antibiotic use.
Related AAFP News Coverage
CDC: Coordinated Approach Needed to Stop Explosion of Drug Resistance
Health Care Facilities, Health Departments Must Collaborate to Reduce Infections, Agency Says