CDC Seeks to Contain Unusual Antibiotic-Resistant Bacteria
An April 3, 2018 report from the Centers for Disease Control and Prevention (CDC) highlights the growing public health threat from antibiotic-resistant bacteria with unusual mechanisms of resistance (UMR). These uncommonly encountered bacteria are typically resistant to most or all antibiotic drugs. They can cause dangerous, difficult-to-treat, or untreatable infections.
The CDC warns that although these bacteria are uncommon now, they could become more prevalent in the future. One in four of the UMR bacteria encountered had special genes that allow them to spread their resistance mechanisms to other bacteria. And once antibiotic resistance spreads, it is hard to contain. People and animals may carry these resistant bacteria in their digestive tract or on their skin without any signs or symptoms of infection (colonization) and transmit them to others. These bacteria may be ingested in food or water and can spread from one healthcare facility to another when infected or colonized patients are transferred among facilities.
The CDC report states that more than 23,000 people in the U.S. die each year from infections caused by multidrug-resistant bacteria. These bacteria, such as carbapenem-resistant Enterobacteriaceae (CRE), can cause hard-to-treat urinary tract infections, blood infections, wound infections, and pneumonia. In 2017, new nation-wide testing through the CDC’s AR Lab Network revealed 221 cases of CRE with unusual mechanisms of resistance. This testing also revealed that roughly 1 in 10 asymptomatic people who were screened were found to carry hard-to-treat bacteria that spread easily.
In response to this growing threat, the CDC recommends “early and aggressive action,” even when a single instance of an antibiotic resistant bacteria with unusual mechanisms of resistance (UMR) is discovered. The CDC has developed a new Containment Strategy coordinated through the AR Lab Network that could keep UMR bacteria from spreading if it is launched at the first sign of UMR bacteria. The Containment Strategy includes rapid identification of UMR bacteria, detecting them in healthy people who may carry and spread UMR bacteria, and continued infection-control practices and assessments until their spread has stopped.
Health departments using the Containment Strategy have conducted infection-control assessments as well as colonization screenings within two days of identifying a bacterial infection with unusual resistance and have reported no additional spread several weeks later. In 2017, more than 4400 CRE were tested by the AR Lab Network for unusual mechanisms of resistance. The CDC estimates that their Containment Strategy could prevent 1,600 cases of CRE over three years in a single state.
In addition, CDC is collaborating with other government agencies to tackle the spread of UMR bacteria by preventing infections and improving antibiotic use. State and local health departments and labs have been urged by the CDC to make sure healthcare facilities know what support is available to them and what kinds of samples they need for testing.
The U.S. Food and Drug Administration (FDA) has also launched several initiatives to address the growing problem of antibiotic-resistant infections. Patient education efforts include emphasizing the proper use of antibiotics, such as:
- Always follow the instructions of your healthcare provider when you are prescribed antibiotics.
- Do not save or take leftover antibiotics or take antibiotics prescribed for someone else. Different antibiotics are prescribed for different infections. If you take the wrong drug for your infection, it could prolong your sickness.
- Understand that antibiotics cannot be used to treat viral infections like colds or the flu because they only work on bacterial infections.
The World Health Organization (WHO) and the CDC recommend the following practices that could also help reduce the spread of multidrug-resistant bacteria:
- Inform your healthcare practitioner if you recently traveled out of the country or received care in another country or facility.
- Talk to your healthcare practitioner about preventing infections, taking care of chronic conditions, and getting recommended vaccines. (Vaccines can protect against some infections that may lead to secondary infections caused by multidrug-resistant bacteria).
- Prevent infections by washing hands frequently and thoroughly, keeping cuts clean until healed, practicing safe sex, and avoiding close contact with sick people.
(April 25, 2018) NIH, U.S. National Library of Medicine, MedlinePlus. Antibiotic Resistance. Available online at https://medlineplus.gov/antibioticresistance.html. Accessed on April 27, 2018.
(April 24, 2018) CDC, Diseases & Conditions. Stop Spread of Unusual Antibiotic Resistance. Available online at www.cdc.gov/features/unusual-antibiotic-resistance/index.html. Accessed on April 27, 2018.
Woodworth K.R., et al. (April 6, 2018) Vital Signs: Containment of Novel Multidrug-Resistant Organisms and Resistance Mechanisms — United States, 2006–2017. MMWR Morb Mortal Wkly Rep. Available online at http://dx.doi.org/10.15585/mmwr.mm6713e1. Accessed on April 27, 2018.
(April 3, 2018) CDC, Newsroom Releases. Germs with Unusual Antibiotic Resistance Widespread in U.S. Available online at www.cdc.gov/media/releases/2018/p0403-antibiotic-resistant-germs.html. Accessed on April 27, 2018.
(April 3, 2018) CDC, Vital Signs. Containing Unusual Resistance. Available online at www.cdc.gov/vitalsigns/containing-unusual-resistance/index.html. Accessed on April 27, 2018.
(March 28, 2018) CDC, Healthcare-Associated Infections, Containment Strategy. Interim Guidance for a Health Response to Contain Novel or Targeted Multidrug-Resistant Organisms (MDROs). Available online at www.cdc.gov/hai/containment/guidelines.html. Accessed on April 27, 2018.
(February 5, 2018) WHO, Fact Sheet. Antibiotic Resistance. Available online at www.who.int/en/news-room/fact-sheets/detail/antibiotic-resistance. Accessed on April 27, 2018.
(January 8, 2018) FDA, Consumer Updates. Combating Antibiotic Resistance. Available online at www.fda.gov/ForConsumers/ConsumerUpdates/ucm092810.htm. Accessed on April 27, 2018.