The CDC’s new quick action approach could slow the spread of drug resistant pathogens, say CDC researchers in their report, Vital Signs, published Tuesday.
Enterobacteriaceae, discovered in 1988 and evolving by 2001, are a family of bacteria that include some of the most common pathogens and cause most of the infections seen in health care settings. They include K. pneumonia, E. coli and salmonella, among many others, and they are found in soil, water, plants and animals.
Many enterobacteriaceae contain genes which encode carbapenemases and extended-spectrum β-lactamases (ESBLs), enzymes that metabolize common antibiotic drugs and make the bacteria resistant to treatment.
In 2009, increasing concerns about the quick spread of carbapenem-resistant Enterobacteriaceae (CRE) prompted the CDC to recommend health care facility guidelines specific to CRE related infections, such as laboratory surveillance and patient screenings. They updated the guidelines in 2013 and 2015. An analysis of data collected by the National Healthcare Safety Network from 2006 to 2015 discovered both lower incidences of and greater decreases over time in infections that were CRE related, compared to those related to ESBLs. The guidelines seemed to be working.
By 2017, the CDC had developed a more aggressive containment strategy to extend their apparent success. They added emphases on rapid detection, coordination across facilities, and nonstop intervention until complete control is gained. Data collected from January to September 2017 suggested that these added efforts were also working. The CDC’s Antibiotic Resistance Laboratory Network (ARLN), established in 2016, increased carbapenemase testing over this period and resultant public health responses rose.
Researchers believe that this strategy can also slow the spread of other drug resistant pathogens and pan-resistant bacteria. As enterobacteriaceae and other bacteria continue to evolve greater resistance, the CDC plans to stay ahead of them. Mathematical modeling, the report stated, “suggests that an intervention resulting in a 20% reduction in transmission would result in … [a] reduction of about 76%, 3 years after introduction.”