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CRE spreads among Washington, D.C., health care facilities
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Carbapenem-resistant Enterobacteriaceae, or CRE, is transmitted within and between a variety of health care settings in Washington, D.C., a study presented at the Society for Healthcare Epidemiology of American spring conference suggests.
In response to the increasing threat of CRE in the United States, Jacqueline Reuben, MHS, an epidemiologist with the D.C. Department of Health, and colleagues conducted a prevalence study to inform prevention efforts. They assessed 16 health care facilities, including eight acute care, two long-term acute care, one inpatient rehabilitation and five skilled nursing facilities.
In all, 1,022 samples, taken at the peri-anal site, were processed. Of these samples, 53 (5.2%) tested positive for CRE.
The researchers found evidence of transmission within and between facilities, Reuben told Infectious Disease News, as they detected matching profiles.
“The similarity of strain profiles was based on organism identification, antibiotic sensitivity and gene identification,” she said. “From these data, one facility identified five samples obtained from patients on the same unit with apparently identical profiles. Four other profiles were identified in two to three facilities.”
The proportion of CRE–positive samples within each facility varied, as compared with that for the total data set.
“The prevalence of positive results among facilities ranged from 0% to 29%, with a median of 2.7%,” Reuben said.
She cautioned that the study was not designed to show potential means of transmission. Rather, the goal was to highlight how common CRE can be.
“The study team did not have a hypothesized prevalence, but we were aware of the prevalence of CRE reported in the region and the endemic rate identified in other major metropolitan cities,” Reuben explained.
“However, most studies have not tested for colonization of CRE outside of outbreak situations, and therefore are unaware of what the actual burden may be. We made it one of our goals to shed light on this topic as a proactive step toward ultimately eliminating the spread of CRE,” she said. – by Joe Green
Reference: Reuben J, et al. Abstract Healthcare Antibiotic Resistance Prevalence Study District of Columbia: Concept to Implementation. Presented at: The Society for Healthcare Epidemiology of America spring conference; March 29-31, 2017; St. Louis.
Disclosure : The researchers report no relevant financial disclosures.