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'Nightmare Superbug' Outbreak Could Happen, CDC Warns

TUESDAY, April 3, 2018 (HealthDay News) -- Efforts to combat antibiotic-resistant bacteria have uncovered hundreds of germs carrying unusual genes that could lead to a "nightmare" superbug, U.S. health officials reported Tuesday.

In 2017, a new nationwide testing program found 221 instances of "unusual" antibiotic-resistance genes that had developed in bacteria causing illnesses in hospitals, nursing homes and other health care facilities, the Centers for Disease Control and Prevention said.

Health officials say these new bacteria must be contained quickly, lest they share their antibiotic-resistance genetics with other potentially more dangerous germs.

If that were to happen, it could lead to the rise of a deadly superbug resistant to all known antibiotics.

"Resistance genes with the capacity to turn regular germs into nightmare bacteria have been introduced into many states," CDC Principal Deputy Director Dr. Anne Schuchat said during a morning media briefing. "With an aggressive response, we've been able to stomp them out promptly and stop their spread between people, between other facilities, and between other germs."

However, 2 million U.S. patients get infections from antibiotic-resistant bacteria each year, and 23,000 die from their infection, she said.

Schuchat compared antibiotic resistance to a spreading fire.

"Germs do more than spread and cause infections in people," she explained. "They can also share their resistance with other germs, making some untreatable. Much like a fire, finding and stopping unusual resistance early, when it's just a spark, protects people."

To attack antibiotic-resistant bacteria, the CDC has developed a nationwide lab network that provides quick analysis of bacteria samples forwarded by state and local health departments.

One out of every four germ samples sent to the Antibiotic Resistance Lab Network for testing in 2017 carried special genes that allow them to spread their resistance to other germs, the CDC said. These have to be stopped quickly before they can share their genes with other bacteria.

The CDC's containment strategy calls for: rapid identification of resistance; assessing infection controls in health care facilities; testing patients without symptoms who may carry and spread the germ; and continued infection-control assessments until the bacteria have stopped spreading.

The CDC noted two recent instances where the strategy paid off:

  • In Tennessee, public health officials found an unusual resistance germ in a patient who had been treated outside the United States. They did a comprehensive investigation within 48 hours, preventing further spread of the bug.

  • In Iowa, the health department screened 30 nursing home patients after identifying an unusual resistance germ in one patient. They determined the germ may have spread to five other people. Infection controls stopped further spread.

These ongoing efforts also show why these cases must be met with rapid containment.

One in every 10 apparently healthy people screened at facilities under investigation were carrying a hard-to-treat germ capable of spreading easily, the CDC reported.

Left undetected, these symptom-free patients could continue spreading rare and hard-to-treat germs throughout a hospital or nursing home.

The CDC estimates that its new containment strategy could prevent as many as 1,600 new infections within three years in a single state. That's a 76 percent reduction.

As evidence that this strategy could work, the agency points to National Healthcare Safety Network data from 2006 to 2015, showing a continued decline in infections of carbapenem-resistant Enterobacteriaceae (CRE).

CRE refers to bacteria that have developed resistance to carbapenems, a class of powerful antibiotics kept in reserve to be used as a last resort against an otherwise untreatable infection.

Targeted efforts to reduce the spread of CRE resulted in a 15 percent decrease in infections every year, the CDC found.

"Increased detection and aggressive early response to emerging antibiotic resistance threats have the potential to slow further spread," the CDC's report concluded.

The "Vital Signs" report, by researchers at the CDC's National Center for Emerging and Zoonotic Diseases, was published April 3 in the agency's Morbidity and Mortality Weekly Report.

More information

The U.S. Centers for Disease Control and Prevention has more about antibiotic resistance.

SOURCES: April 3, 2018, media briefing, Anne Schuchat, M.D., principal deputy director, U.S. Centers for Disease Control and Prevention; April 3, 2018, Morbidity and Mortality Weekly Report, online

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