Washington, D.C., facilities demonstrated 5% CRE prevalence

Roughly 5% of all inpatients in Washington, D.C., health care facilities tested positive for carbapenem-resistant Enterobacteriaceae, according to findings recently published in Infection Control & Hospital Epidemiology.

 “CRE is a significant clinical and public health concern, with a potential for widespread and rapid transmission within and between facilities,” Roberta DeBiasi, MD, MS, chief of infectious diseases at Children’s National Medical Center, said in a press release accompanying the study. “Our study demonstrates the strength of a collaborative approach within a city or region to determine the prevalence of multidrug resistant organisms in health care facilities.”

DeBiasi and colleagues performed a point-prevalence study as part of a coordinated effort among three agencies: the D.C. Department of Health, the D.C. Hospital Association and the D.C. Department of Forensic Science-Public Health Lab. Researchers identified CRE in perianal swabs from patients in 16 health care facilities, including eight acute-care hospitals, five skilled nursing facilities, one inpatient rehab facility and two long-term acute-care facilities. DeBiasi and colleagues then calculated prevalence by dividing the number of patients with a positive result by the total number of patients tested for each unit.

Overall, 53 samples out of 1,022 completed tests were positive, resulting in a 5.2% CRE prevalence, the researchers reported.  Acute care hospitals made up 726 tests, of which 36 (5%; 95% CI, 3.5-6.9%) were positive. Two hundred forty-four tests came from long-term care facilities, 7% of which were positive (n = 17; 95% CI, 4.1%-11.2%). The relative prevalence ratio was 0.9 for acute care facilities (95% CI, 0.5-1.5) and 1.5 (95% CI, 0.9-2.6) for long-term care facilities, DeBiasi and colleagues wrote. No patients in the rehab facility (n = 52) tested positive for CRE.

“The study represents a unique collaboration of cutting-edge science, public health concern, dedicated investigators and selfless patient-volunteers who came together to successfully complete this investigation,” Glenn Wortmann, MD, section direct of infectious diseases at MedStar Washington Hospital Center, said in the press release. “The results will hopefully guide future efforts to control the spread of multidrug resistant bacteria.” – by Andy Polhamus

Disclosure: DeBiasi reports no relevant financial disclosures. Please see the full study for a complete list of all other researchers’ relevant financial disclosures.