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 Coordinated Approach Needed To Combat Antibiotic Resistance: CDC

The Centers for Disease Control and Prevention (CDC) released today in its "Vital Signs" report two mathematical models that confirm the need for more coordination among health facilities and state health departments to curb the rise of antibiotic-resistant bacteria.
These multisyllabic superbugs, some of which are better known by their abbreviations—Clostridium difficile, CRE (carbapenem-resistant Enterobacteriaceae), MRSA (methicillin-resistant Staphylococcus aureus) and Pseudomonas aeruginosa—cause more than 2 million illnesses and at least 23,000 deaths each year in the United States, according to the agency.
“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, MD, MPH. “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.”
Bacteria containment should not just be a single facility problem. Even facilities that follow recommended infection control and antibiotic use practices are at risk when they receive patients who carry these germs from other health care venues.
The models—using U.S. infection and mortality data from CDC and working with Johns Hopkins Bloomberg School of Public Health, the University of Utah, and the University of California Irvine School of Medicine—show that if health care facilities and their state health departments band together, then they could prevent up to 70 percent of life-threatening CRE infections over five years.
CDC recommends a one-two punch. Public health departments should track and alert health care facilities to drug-resistant germ outbreaks in their areas and the threat of germs coming from other facilities. In turn, health care facilities should work closely with public health authorities to implement shared infection control actions.
These coordinated efforts are slated for funding by the State Antibiotic Resistance Programs (Protect Programs) that have been proposed in the president’s FY 2016 budget request. A current five-year plan, the National Strategy to Combat Antibiotic-Resistant Bacteria, hopes to cut the incidence of C. difficile, health care CRE, and MRSA bloodstream infections by at least half.
“We must transform our public health response to turn the tide,” says Beth Bell, MD, MPH, director of CDC’s National Center for Emerging and Zoonotic Infectious Diseases.
In response to this growing clinical crisis, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) is taking a number of specific actions to enhance antibiotic stewardship among its membership. The lead advocate for long term and post-acute providers joined key federal agencies and private-sector organizations at a recent White House Forum on Antibiotic Stewardship. The association also added the goal of reducing hospitalizations resulting from health care-acquired infections to its nationwide Quality Initiative.
“AHCA/NCAL commends CDC for promoting a coordinated approach in preventing health care-associated infection (HAI) and antibiotic resistance,” says AHCA Senior Director of Clinical Services Holly Harmon, RN, MBA, LNHA. “We have witnessed the strength that coordinated partnership efforts bring to achieve better outcomes.”
Currently, AHCA/NCAL is working with the American Hospital Association to prevent catheter-associated urinary tract infections, as well as with Advancing Excellence in America’s Nursing Homes and its goal to reduce C. difficile infections through better antibiotic stewardship.
Jackie Oberst is Provider’s managing editor. Email her at joberst@providermagazine.com. Follow the magazine on Twitter @ProviderMag.
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