Carbapenem-resistant
Enterobacteriaceae (CRE), a family of highly pathogenic antibiotic-resistant
organisms, are endemic across Washington, D.C. healthcare facilities, with 5.2
percent of inpatients testing positive for the bacteria, according to new
research.
As part of the Healthcare Antibiotic
Resistance Prevalence -- DC (HARP-DC) project, the three agencies partnered to
conduct a multi-center study of CRE in D.C. Sixteen facilities voluntarily
participated, including eight acute care hospitals, two long-term acute care
hospitals, one inpatient rehabilitation facility, and five skilled nursing
facilities. Each facility conducted bacterial colonization surveillance over a
one-to-three-day interval from January to April, 2016. The researchers used the
Centers for Disease Control and Prevention CRE surveillance definition and
tested all cultures at a single laboratory to ensure consistency.
Of 1,022 completed tests, 53 samples
tested positive for CRE, which corresponds to a prevalence rate of 5.2 percent,
confirming that CRE has become endemic in healthcare facilities in Washington,
D.C. The median prevalence rate by facility was 2.7 percent, with one facility
measuring as high as 29.4 percent of tested patients, indicating the potential
for hyperendemicity. Male patients had a significantly higher prevalence of CRE
compared to females (7.1 percent vs. 3.7 percent). Adults ages 20-39 (8
percent) also showed higher prevalence than any other age group.
Of the positive samples, 18 were
determined to share genetic similarity with at least one other sample. This
revealed the potential transmission of CRE within and between facilities. The
ability to determine similarity of strain profiles from culture and molecular
testing also enabled the researchers to detect an ongoing outbreak in one
facility, further demonstrating the utility of these laboratory techniques for
surveillance programs.
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Posted by Dr. Tim Sandle