Kokomo Tribune; Kokomo, Indiana

March 13, 2013

Hospitals taking “super bug” precautions

Bacteria is resistant to most antibiotics.

By Ken de la Bastide
Tribune enterprise editor

Kokomo — The latest “super bug” to hit health care facilities in the U.S. that can be resistant to all available antibiotics and is being called an important threat to public health, according to the Center for Disease Control.

Carbapenem-resistant Enterobacteriaceae was diagnosed last year in two patients at St. Joseph Hospital.

To become infected a person must be exposed to the CRE bacteria and are most often spread person-to-person in healthcare settings through contact with infected or colonized people, particularly contact with wounds or stool, the CDC reports. It can cause infections when the bacteria enters the body, often through medical devices, wounds or during surgery.

The CDC is reporting that CRE infections are spreading and has been reported in 42 of the 50 states. It is advising physicians to follow hand hygiene procedures, dedicate rooms, staff and equipment for CRE patients, prescribe antibiotics wisely and remove temporary medical devices like catheters and ventilators as quickly as possible.

St. Joseph Hospital saw two cases last year and the hospital has taken precautions to prevent the spread of CRE.

April Roles, infection control manager at St. Joseph, said CRE has a 40 percent to 50 percent mortality rate.

She said CRE has been found by labs testing for something else and that the hospital doesn’t normally check for CRE.

“The high risk patients are people who have been in a hospital outside the country,” Roles said. “Our community is generally a low risk area.”

Roles said patients identified with CRE are isolated and hospital staff and visitors are told to wash their hands, wear gloves, caps and gowns.

She said patients would be placed in private rooms and kept away from other patients with an infection.

“We’re seeing more and more organisms that are resistant to antibiotics,” she said. “The drug companies are not creating a lot of new antibiotics because of the cost and its not profitable.”

Roles said people with pre-existing conditions, a weakened immune system or fighting another infection are at the highest risk.

The CDC said CRE causes a variety of diseases from pneumonia to urinary tract infections, to serious bloodstream or wound infections.

Roles said the hospital has antibiotics that could fight CRE and the staff works to determine which antibiotic is effective.

“The most important part is hand washing,” she said.

Dr. Carl Kuenzli, a doctor of internal medicine at Community Howard Regional Health Systems, said the hospital has not seen a CRE case.

“We would rather keep it out of the community,” he said.

Kuenzli said a lot of bacteria is becoming resistant to a lot of antibiotics.

“It is attacking people where the immune system is already weakened,” he said.

Kuenzli agreed that appropriate hand washing is the best defense in contracting or spreading CRE.

Ken Severson, spokesman for the Indiana State Health Department, said because CRE is not a reportable condition or disease, no data on the number of cases in Indiana is available.

He said the Health Department is considering how to conduct surveillance on CRE, but hasn’t been finalized.