Deadly ‘Superbugs’ on the RiseMeghan Luce

HSPH 202

December 3, 2012

Overview:

• Compared articles from Fox News and USA Today (compiled data from University of Virginia Health Systems) along with information from the CDC and State Health Departments

• The article discusses the emergence and rise of incidence rates of Carbapenem-Resistant Enterobacteriaceae (CRE)

Image of KPC-form of pneumonia

Summary & Background

• Since 2001 there has been the emergence of a new antimicrobial resistant bacteria- CRE

• The bacteria is spread by mobile pieces of DNA that move between species of bacteria, creating new resistant bacteria.

• CRE is resistant to all known antibiotics, even those considered ‘drugs of last resort’ by physicians.

• So far CRE is only liked to health care facilities, most commonly hospitals, attacking patients with weakened or compromised immune systems

Summary & Background

• CRE first gained national attention after 7 deaths were reported in Washington D.C. after the patients contracted KPC.

• Since then research has shown there have been thousands of CRE cases nation wide.

• Death rates among infected individuals is about 40 % (lack of standard data and methodology make accuracy limited).

• CRE was first reported in North Carolina in 2001 and has since spread to 41 states, but many cases go unrecognized.

• 1 year of surveillance recorded 675 new cases in Los Angeles and 269 new cases in Maryland.

Preventive Measures

• Preventive Measures are strongly stressed in both articles and by both Health Departments.

• Preventive guidelines from the CDC: rigorous hand washing by staff and hospital visitors, isolating infected patients, cutting antibiotic use to slow the development of resistant bacteria, screening patients or potential hosts, and limiting the use of invasive medical devices, like catheters, that give bacteria a passage into the body.

Future Challenges & Recommendations

• Many health care centers that are a potential risk for CRE outbreaks are not equipped for early detection or screening populations (labs).

• CRE spreads rapidly between bacteria so the challenge comes with developing appropriate antibiotics timely and making them accessible.

• Need for more epidemiological surveillance to start collecting incidence rates and other population data to better track the development of CRE. Lack of standard methodology raises many areas of concern with existing data.

• Data collected from epidemiological surveillance can better help target at risk populations and help develop prevention campaigns.

VIDEO:http://www.usatoday.com/story/news/2012/11/29/bacteria-deadly-hospital-infection/1727667

How the Articles Differ

• Fox News failed to mention how the bacteria spreads, or what common infections CRE can become present in.

• USA Today and Fox News also viewed the spread differently, the first siting mobile pieces of DNA and the second siting skin contact.

• USA Today doesn’t provide information links, Fox News provides a link to the CDC which is not designed for quick information (a challenge in todays high speed world).

• http://www.cdc.gov/hai/organisms/cre/cre-toolkit/index.html

Questions

• What would you design as an effective prevention campaign?

• Do you think there has been enough information about CRE?

References

• USA Today: http://www.usatoday.com/story/news/nation/2012/11/29/bacteria-deadly-hospital-infection/1727667/

• Fox News: http://www.foxnews.com/health/2012/09/18/deadly-uperbugs-on-rise-what-need-to-know/

• CDC: http://www.cdc.gov/hai/organisms/cre/cre-toolkit/index.html

• Minnesota State Departement of Health:http://www.health.state.mn.us/divs/idepc/dtopics/cre/basics.html