CDC asks for States’ help on antibiotic resistance

As infections become more drug-resistant and harder to treat, prevention is key.   Good hospital infection control and improved antibiotic use have been important aspects of this effort, but the U.S. Centers for Disease Control and Prevention (CDC) added two new elements to the public discussion last week– better communication during interfacility transfer,  and involvement of the Local Health Department.

These recommendations coincided with the release of a study August 4 in the CDC’s Morbidity and Mortality Weekly Report (MMWR), in which the authors argue that one of the most effective means of prevention is better communication about patients known to be infected or colonized during transfer to other facilities.   The authors go on to propose that this coordinated effort may need to be led by State Health Departments, not by individual facilities and healthcare systems.

“If you’re a hospital doing a great job but the hospital down the street isn’t, your patients are at risk,” CDC director Dr. Tom Frieden told reporters. “Facilities that go it alone can’t protect their own patients.”

According to the mathematical modeling used for the report, intensive collaboration led to a significant reduction in the 4 dangerous infections they studied–CRE, multidrug-resistant Pseudomonas aeruginosa, invasive MRSA, and C. difficile.

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Announcement of this plan is an elaboration upon efforts in the works for almost 1 year. President Obama signed Executive Order 13676 on September 18, 2014, ordering the coordination of a task force to address the issue of antibiotic resistance and to compose a 5-year action plan, released in March 2015.  The National Strategy for Combating Antibiotic-Resistant Bacteria includes budgeting $264 million to the Antibiotic Resistance Solutions Initiative (ARSI), of which the State AR Prevention Programs are a part.  Other aspects of the plan address detection and prevention within the food supply, the development of new drugs and vaccines, improving tests and the utilization of tests, and international collaboration.

The authors state in the conclusion of the August 4, 2015 MMWR:  “Because health departments possess substantial expertise in surveillance and prevention, they are well equipped to partner with multiple stakeholders, including hospitals, corporate and academic institutions, hospital associations, professional organizations, quality improvement organizations, and federal partners. Such state-based HAI antibiotic-resistance prevention programs can enable communities to locate the threat by sharing antibiotic resistance data and promoting accurate testing. Such programs also can respond quickly to prevent spread by identifying and rapidly responding to clusters, implementing a regionally coordinated response that includes opening lines of communication between facilities, helping individual hospitals improve infection prevention practices, and strategically targeting resources to prevent spread and maximize community impact.”



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