A simulation of how the so-called “superbug” carbapenem-resistant Enterobacteriaceae (CRE) might spread among health care facilities found that coordinated efforts prevented more than 75 percent of the often-severe infections that would have otherwise occurred over a five-year period.
The study was led by researchers at the Johns Hopkins Bloomberg School of Public Health and published last month in the American Journal of Epidemiology.
Superbugs such as CRE are antibiotic-resistant bacteria for which there are limited or no treatments. CRE is most commonly found in health care facilities and the CDC says the germ can kill up to half of those it infects. Patients in hospitals and nursing homes are thought to be more susceptible to superbugs in general because of the potentially high rate of exposure among vulnerable patients, many of whom transfer from one facility to another while infected, bringing the bugs with them. Superbugs are considered a serious public health threat and the U.S. Centers for Disease Control and Prevention (CDC) has issued a “toolkit” to assist health care facilities to create plans to stem their spread – a blueprint that walks management through steps from persuading leadership to measuring outcomes.
For their new analysis, the researchers simulated how CRE would spread across health care facilities in Orange County, California, under three scenarios. The first involved no extra interventions. The second involved interventions at individual facilities, including testing transfer patients for CRE upon admission and, for patients who test positive, using contact precautions such as gloves and gowns. The third scenario used those same two interventions but coordinate efforts among facilities when the number of CRE cases reached a certain threshold. The researchers did not detail how facilities would communicate but assumed that an advance communications plan would be in place.