MedicalResearch.com Interview with:
Rachel Slayton PhD
National Center for Emerging and Zoonotic Infectious Diseases
Medical Research: What is the background for this study? What are the main findings?
Antibiotic-resistant bacteria cause more than 2 million illnesses and at least 23,000 deaths each year in the US. Additionally, Clostridium difficile
caused close to half a million illnesses in 2011, and an estimated 15,000 deaths a year are attributable to C. difficile
infections. Antibiotic resistance is a regional problem with inter-facility spread through movement of patients who are colonized or infected with these organisms.
In our first analysis we projected the national incidence of infections and deaths from Carbapenem-resistant Enterobacteriaceae
(CRE), Clostridium difficile
, invasive methicillin-resistant Staphylococcus aureus
(MRSA), and multidrug-resistant Pseudomonas aeruginosa
. With immediate implementation of national interventions combining infection control and antibiotic stewardship and, assuming similar effectiveness to that reported in other countries, an estimated 619,000 health care–associated infections and 37,000 deaths could be averted over 5 years.
Using CRE as an exemplar, we also estimated the effect of a coordinated approach in a network for the preventing the spread of antibiotic-resistance organisms among healthcare facilities that share patients. Our Carbapenem-resistant Enterobacteriaceae
modeling was done in collaboration with Johns Hopkins Bloomberg School of Public Health, the University of Utah, and University of California Irvine School of Medicine. Both models clearly show that we could see fewer antibiotic-resistant infections if health care facilities and public health officials work together as a team. For example, five years after Carbapenem-resistant Enterobacteriaceae
enters an area with 10 facilities that share patients, baseline activity alone resulted a prevalence of healthcare-associated CRE infection or colonization of 12.2% with 2,141 patients acquiring CRE. With independent facility-augmented efforts, we estimated that there would be an 8.6% prevalence with 1,590 patients acquiring Carbapenem-resistant Enterobacteriaceae
. With a coordinated augmented approach, we estimated that there would be a 2.1% prevalence with 406 patients acquiring CRE. Using a 102-facility model of Orange County, California, we estimated that over 15 years countywide 19,271 patient acquisitions could be prevented with the coordinated augmented approach compared with independent-facility efforts. (more…)