Becker's Hospital Review

65 FINANCE CMO / CARE DELIVERY CDC: Unusually resistant 'nightmare bacteria' stalk US hospitals By Megan Knowles T he CDC found more than 200 cases in 2017 of unusual resis- tance genes in "nightmare bac- teria" that can cause difficult-to-treat or potentially untreatable infections, according to a CDC Vital Signs report released April 3. The report looked at new and high- ly resistant germs that are not yet widespread. However, a variety of these resistant germs can still be de- tected in every state. A number of germs within one family of bacteria, Enterobacteriaceae, can produce an enzyme that is able to break down common antibiotics. By 2001, the germs started to evolve, becoming increasingly resistant to antibiotic drugs. The CDC dubbed these carbapenem-resistant Entero- bacteriaceae "nightmare bacteria" because they spread rapidly across the U.S. and around the world. More than 23,000 Americans die annually from infections caused by germs re- sistant to antibiotics, according to the CDC report. When testing more than 5,000 iso- lates of antibiotic-resistant germs from hospitals and nursing homes, the CDC found approximately 1 in 4 possessed a gene that helped spread its resistance, while 221 contained an "especially rare resistance gene," said Anne Schuchat, MD, acting principal deputy director of the CDC, accord- ing to CNN. Approximately 1 in 10 contacts also tested positive during follow-up screening, "meaning the unusual re- sistance had spread to other patients and could have continued spreading if left undetected," Dr. Schuchat said. However, Dr. Schuchat noted it is not known how frequently "asymptomatic carriers" spread the disease to unin- fected people. Since this marks the first testing for rare genes, the CDC cannot present trend data yet, Dr. Schuchat said. However, she hopes this will not indi- cate the "beginning of an inevitable march upwards." The CDC is promoting an aggres- sive "containment strategy," which includes rapid detection tests and screening for reducing the spread of antibiotic resistance. "CDC estimates show that even if only 20 percent ef- fective, the containment strategy can reduce the number of nightmare bac- teria cases by 76 percent over three years in one area," Dr. Schuchat said. The CDC report suggests healthcare facilities plan for unusual resistance, and healthcare leaders work with the local health department to prevent unusual resistance spread and sup- port infection control in the facility. Additionally, the CDC recommends clinical labs know what isolates to send for testing, establish protocols that immediately notify the health department, healthcare provider and infection control staff of unusual resis- tance, and validate new tests to identi- fy the latest threats. Healthcare providers, epidemiolo- gists and infection control staff can place patients with unusual resistance on contact precautions, enhance in- fection control, work with the health department to screen patients, and continue infection control assess- ments and colonization screenings until the spread is controlled. n Poll: How patients define 'good' healthcare across conditions By Megan Knowles P atients with certain conditions, par- ticularly those with fibromyalgia, post-traumatic stress disorder and ma- jor depressive disorder, are least satisfied with their provider or care, while those with Lou Gehrig's disease, multiple sclerosis and Par- kinson's disease are among the most satisfied, according to a poll from the patient network and research platform PatientsLikeMe. To determine how opinions about care and provider performance varied across patient groups, PatientsLikeMe gathered data from 2,559 of its members in a six-question online poll administered in February. Overall, poll respondents indicated differing care experi- ences based on their condition. Here are four findings from the poll. 1. Only 47 percent of fibromyalgia and PTSD pa- tients and 53 percent of MDD patients believe their provider has fully explained treatment options, compared to 63 percent of patients living with ALS, MS and Parkinson's disease. 2. Only 40 percent of fibromyalgia patients, 49 percent of PTSD patients and 45 percent of MDD patients think they are getting the best possible care for their condition, com- pared to 66 percent of ALS patients, 61 per- cent of MS patients and 57 percent of Parkin- son's disease patients. 3. More than half — 53 percent of PTSD and 56 percent of both MDD and fibromyalgia patients — have stayed with their providers despite thinking they are not receiving the best care or treatment, compared to only 31 percent of ALS patients and 36 percent of MS and Parkinson's patients. 4. "A positive or negative experience with care could be provider-related, but also related to the fact that patients living with ALS, MS and Parkinson's oen have access to condi- tion-specific specialists or centers of excel- lence while those living with other conditions do not," said PatientsLikeMe's Vice President of Policy and Ethics Sally Okun, RN. "is makes it even more important that patients advocate on their own behalf to ensure all av- enues to get good care are being used." n

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