Hospital staffs across the country are doubling down on their efforts to stop the spread of hospital acquired infections (HAIs.) While progress has been made in understanding and reducing the spread of MRSA, C. diff and other germs, there is a growing and far more deadly threat – carbapenem-resistant Enterobacteriaceae, or CRE.
CRE germs are resistant to antibiotics of last resort, killing one of every two patients who get bloodstream infections from them. But it could be worse. CRE can transfer their antibiotic resistance to other bacteria such as E. coli, making the most common cause of urinary tract infections extremely difficult to treat. Ultimately, CRE could get out into our communities, leading to a public health crisis.
For these reasons, CDC has sounded the alarm. In the March Vital Signs report, CDC published some alarming facts. CRE has increased from 1% to 4% in the past decade, and one type of CRE has increased from 2% to 10%. CRE is more common in the Northeast, but has been reported in 42 states. About 18% of long-term care hospitals have reported at least one CRE infection during the first half of 2012.
The report also provides detailed information on what state governments, communities, health care CEOs, health care providers and patients can do to help stop the spread of CRE.
There are eight core measures for acute and long-term care facilities to implement, and at the top of the list are hand hygiene and the proper use of contact precautions. This includes the proper use of medical gloves.
- Hand hygiene should be performed before donning a gown and gloves.
- Gown and gloves should be donned before entering the affected patient’s room.
- Gown and gloves should be removed and hand hygiene performed, prior to exiting the patient’s room.
In the 2012 CRE Toolkit, the CDC states, “It is not enough to have policies that require hand hygiene; hand hygiene adherence should be monitored and adherence rates should be fed directly back to front line staff. Immediate feedback should be provided to staff who miss opportunities for hand hygiene.”
By following CDC guidelines for CRE, several states have decreased their CRE infection rates. Colorado is one of six states that currently require hospitals to report CRE to the Department of Public Health and Environment. Because they are detecting and tracking the bacteria, an outbreak of CRE at the University of Colorado Hospital last August was halted.
In Florida, a year-long CRE outbreak was finally brought to an end when the facility improved its use of CDC recommendations, including the proper use of medical gloves and gowns. This underlines the importance of proper gloving and hand hygiene, as routine as it may seem.
There is no longer any room for complacency. This is a critical time here in the U.S. CRE infections can be controlled if everyone involved in patient care does their part and puts forth consistent effort to follow infection control recommendations with every patient.
What do you think? Can more be done to stop the spread of CRE? Post your comments below.