Carolinas HealthCare System steps up efforts against ‘superbug’

Carolinas Medical Center ..
Carolinas Medical Center .. mhames@charlotteobserver.com

Carolinas HealthCare System is stepping up its efforts to combat the spread of an antibiotic-resistant “superbug” that has claimed the lives of two Charlotte-area people in recent months and sickened more than a dozen others, officials said Sunday.

Citing medical privacy laws, Carolinas HealthCare officials did not release specifics about the people who have died from carbapenem-resistant Enterobacteriaceae, commonly known as CRE, during a news conference Sunday.

But because of the threat, officials said, the Charlotte-based hospital system has started screening patients from populations likely to have CRE. Once identified, CRE patients are isolated from other patients. When they’re released, the hospital takes extra steps to decontaminate their rooms.

Even so, three people have acquired CRE at Carolinas HealthCare System hospitals this year, officials said Sunday. An additional 15 have come into hospitals with existing CRE infections.

The family of bacteria that includes CRE is highly resistant to antibiotics and difficult to treat. Some strains can kill half of the people they infect, according to the federal Centers for Disease Control and Prevention.

CRE has been reported in all but three states, according to the CDC. Last week, the University of California at Los Angeles reported that 179 patients at Ronald Reagan UCLA Medical Center were exposed to CRE during endoscopic procedures between October and January. The bacteria may have contributed to the deaths of two patients, according to the university.

“The CDC put out an alert saying this is one of the most urgent threats to health care in the United States,” said Dr. Katie Passaretti, medical director for infection prevention at Carolinas HealthCare. “It’s a relatively new one but one that is definitely increasing in frequency.”

CRE typically affects the sickest patients – people in long-term care facilities or who use devices like ventilators and urinary catheters for long periods of time. Endoscopes like the ones used at UCLA have also been scrutinized, and Carolinas HealthCare has changed how it cleans the devices.

When the hospital identifies a patient with CRE, they’re isolated. CRE patients have a nursing staff that doesn’t interact with other patients. Hospital workers who treat CRE patients have to wear gowns and gloves that are discarded before they leave the room.

Passaretti said the hospital also aggressively cleans the rooms of CRE patients who are released from the hospital, even using a device that kills bacteria with ultraviolet light.

Hospitals in the United States have been contending with CRE for more than a decade.

About 5 percent of patients, roughly 1.7 million people, get an infection in the hospital each year, and about 100,000 die as a result, according to the CDC. The cost for treatment is high – from $28 billion to $33 billion.

To further encourage hospitals to reduce infection rates, Medicare and Medicaid have stopped reimbursing for the extra care needed to treat some hospital-acquired infections. That means hospitals have to absorb the cost. Staff writer Karen Garloch contributed.

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