Becker's Clinical Quality & Infection Control

22 ANTIBIOTIC RESISTANCE Los Angeles County Now Requires Hospitals to Report CRE Infections By Alyssa Rege L os Angeles County will require hospitals to report patients infected with carbapen- em-resistant Enterobacteriaceae, or CRE, a deadly superbug with the potential to kill nearly half the individuals that contract the bacteria, according to the Los Angeles Times. Los Angeles County had stopped requiring hospitals in its district to report patients who contracted the bacteria in 2012 due to "resource limitations," according to the article. Now, hospi- tals will be required to do so. Dawn Terashita, deputy director of the county's acute communicable disease control program, said nursing homes and clinics won't be re- quired to report patients with CRE. Hospitals will also not be required to report whether patients with CRE survive or die. There have been three reported instances of CRE infection in the county since 2014. The cas- es were traced back to a type of medical scope that had been proven to be particularly difficult to disinfect, according to the article. The CDC has advised all municipal health offi- cials to require health facilities to report cases of CRE, or, at minimum, survey hospitals and nursing homes for evidence of the superbug. n UN Makes Historic Move on Antibiotic Resistance: 5 Things to Know By Heather Punke A ll 193 United Nation member states agreed in a declara- tion Sept. 21 to address the growing threat of antibiotic resistance, according to The Guardian. Here are five things to know about the U.N.'s approach to combating antibi- otic resistance. 1. Making history. The high-level meeting on antimicrobial resistance was just the fourth time the U.N. General Assembly had discussed a health issue — the others were HIV, noncommu- nicable diseases and Ebola. 2. Building blocks. The countries pledged commitment to build action plans based on the "Global Action Plan on Anti- microbial Resistance," developed in 2015 by the World Health Organization, the Food and Agriculture Organization of the United Nations and the World Organization for Animal Health. 3. The plan. Each country will come up with a plan to monitor antibiotic use in healthcare and in agriculture, start reducing the drugs' use and also begin developing new antibiotics, accord- ing to NPR coverage. They will present their plans to the U.N. General Assembly in 2018 for a progress assessment. 4. Reason for optimism. "I think this is the first realistic chance, in our lifetime, to turn this around," Keiji Fukuda, MD, special representative for antimicrobial resistance to the director-gen- eral of WHO, told NPR. A similar U.N. declaration in 2001 on HIV helped the world make progress on that disease. 5. Potential weaknesses. The declaration did not set solid goals for antibiotic use reduction, and it is nonbinding, The New York Times reports. n Poultry Meat Can Spread MRSA to Humans, Study Shows By Heather Punke P eople can contract methicillin-re- sistant Staphylococcus aureus strains from poultry even without direct exposure to livestock, according to research published in Clinical Infectious Diseases and covered by Newswise. MRSA is oen found on livestock like chickens, pigs and other animals raised for slaughter. is puts farmers, farm workers, veterinarians and others in direct contact with such animals at risk of MRSA colonization and infection. However, people with no such exposure are now becoming colonized and infected with poultry-associ- ated MRSA. "is is one of the first studies providing compelling evidence that everyday consum- ers are also potentially at risk," said Lance Price, PhD, director of the antibiotic resis- tance action center at the Milken Institute School of Public Health at George Washing- ton University in Washington, D.C. For the study, researchers examined 10 people in Denmark who were colonized or hospitalized with MRSA. Using genetic anal- ysis, they found that while none of the Danes worked on farms or had contact with food animals, they had a novel strain of poul- try-associated MRSA connected to poultry meat from other European Union countries. "At present, meat products represent only a minor transmission route for MRSA to humans, but our findings nevertheless un- derscore the importance of reducing the use of antibiotics in food-producing animals as well as continuing surveillance of the animal-food-human interface," Robert Skov, MD, with Statens Serum Institut, Demark's equivalent of the CDC, told Newswise. "I fear that if we don't get antibiotic use in livestock under control, then new, more vir- ulent strains of livestock-associated MRSA will emerge that pose a much greater threat to human health than what we are currently facing," Dr. Skov added. n

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