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CDC: Coordinated reduction in antibiotic-resistant infections could save 37,000 lives over 5 years
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The CDC estimated that coordinated efforts against antibiotic-resistant and Clostridium difficile infections in both small and large health care alliances would prevent 37,000 deaths over a 5-year period, according to a recent Vital Signs report.
Using a coordinated approach, public health departments would observe and alert local health care facilities on outbreaks of drug-resistant pathogens in the region and collaborate with health care facilities and public health authorities to reduce the spread of infection. Such efforts would be more effective in preventing transmission within and across medical facilities compared with independent efforts and would save roughly $7.7 billion in direct health care costs over 5 years, according to the researchers.
Rachel B. Slayton, PhD, from the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, and colleagues used data from the CDC’s National Healthcare Safety Network and Emerging Infections Program to project the number of infections and deaths caused by carbapenem-resistant Enterobacteriaceae, multidrug-resistant Pseudomonas aeruginosa, MRSA and C. difficile during the next 5 and 15 years. The researchers then used two models to assess the impact that a coordinated approach would have in a 10-facility and 102-facility alliance.
Using the current approach, the model predicted that if drug-resistant bacteria entered a 10-facility area, 2,000 patients would develop CRE during the next 5 years, or 12% of patients. If a facility were to independently combat antibiotic-resistant infections, the number of patients infected with CRE would decrease to 1,500, impacting 8% of patients.
“That’s still not good enough,” Thomas R. Frieden, MD, MPH, director of the CDC, said during a telebriefing. “In fact, no one facility can stop this because the outbreak moves across facilities around a community.”
Thomas R. Frieden
If facilities work together and alert surrounding facilities of CRE issues before transferring patients, about 400 patients would develop CRE, impacting only 2% of patients, the report said.
Overall, a coordinated approach would prevent 619,000 health care-associated infections from CRE, P. aeruginosa, MRSA or C. difficile over 5 years, the report said. Compared with independent action, the 10-facility model predicted that CRE transmission would be reduced by 74% over 5 years, and the 102-facility model predicted a 55% reduction over 15 years.
“Working together, plainly said, is better than working alone,” Frieden said. “We need to think in terms of the whole community. Facilities which go it alone can’t effectively protect their own patients. If you’re a hospital doing a great job but the hospital across town or the doctor down the street is not doing a good job, your patients are at risk.”
To implement a national coordinated intervention, a budget increase of $264 million was proposed to support the program. In addition, Frieden said, changes made at the state level are critical as health departments have “unique access to data across facility types.”
“Not all health departments will be prepared to take on this coordination, and we know that,” he said. “That’s one reason why we requested funds in the fiscal year 2016. These funds will also make it possible to find outbreak sooner, improve laboratory testing and track antibiotic resistance much better than we can today. Without those investments, we will continue to struggle, and patients will continue to get infections that could have been prevented.”
Close correspondence with health care facilities and administrators also are key because they are capable of implementing alert systems, reviewing and improving infection control, establishing stewardship programs and allowing provider access to prompt and accurate testing, Frieden said.
“This Vital Signs is really a call to action,” he concluded. “If we just stay with business as usual, there will be hundreds of thousands of infections and tens of thousands of deaths that could be prevented. We know what needs to be done, and now, frankly, it’s up to Congress to support the resources needed to protect Americans from drug-resistant bacteria.” – by Stephanie Viguers
Disclosure : The researchers report no relevant financial disclosures.
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