Superbug Endemic Within Washington D.C. Hospitals

Approximately 5 percent of inpatients in Washington DC area hospitals have tested positive for an often-deadly superbug, according to new research published on June 15, 2017.

This superbug, Carbapenem-resistant Enterobacteriaceae (CRE), is a family of highly pathogenic antibiotic-resistant organisms and are endemic across Washington, D.C. healthcare facilities.

Of 1,022 completed tests, 53 samples tested positive for CRE, which corresponds to a prevalence rate of 5.2 percent, confirming that CRE has become endemic in healthcare facilities in Washington, D.C.

Healthy people usually do not get CRE infections. Infections with these germs are very difficult to treat, and can be deadly.

"CRE is a significant clinical and public health concern, with a potential for widespread and rapid transmission within and between facilities. Our study demonstrates the strength of a collaborative approach within a city or region to determine the prevalence of multi-drug resistant organisms in healthcare facilities," said Roberta DeBiasi, MD, MS, a principal investigator of the study and division chief of infectious diseases at Children's National Medical Center.

As part of the Healthcare Antibiotic Resistance Prevalence - DC (HARP-DC) project,  three agencies partnered to conduct a multi-center study of CRE in D.C. Sixteen facilities voluntarily participated, including eight acute care hospitals, two long-term acute care hospitals, one inpatient rehabilitation facility, and five skilled nursing facilities.

Each facility conducted bacterial colonization surveillance over a one-to-three-day interval from January to April, 2016. The researchers used the Centers for Disease Control and Prevention (CDC) CRE surveillance definition and tested all cultures at a single laboratory to ensure consistency.

Glenn Wortmann, MD, a principal investigator of the study and section director of infectious diseases at MedStar Washington Hospital Center said, "The results will hopefully guide future efforts to control the spread of multi-drug resistant bacteria."

Traditionally, healthcare facilities would actively work to reduce CRE only after an outbreak was identified.

As a result of this study, healthcare facilities were able to establish a baseline prevalence of CRE in Washington, D.C., and demonstrate the ability to work together to identify and prevent future outbreaks of dangerous antibiotic-resistant organisms.

Corresponding author:  Jacqueline Reuben, DC Department of Health, Center for Policy Planning and Evaluation, 899 N Capitol St NE, 6th Floor, Washington, DC 20001 ([email protected]).

CDC is funding some states who are testing the use of “Detect and Protect” strategies to find germs causing healthcare-associated infections (HAI) and prevent their spread.