Deadly Bacteria That Resist Strongest Drugs Are Spreading

 

Deadly infections with bacteria that resist even the strongest antibiotics are on the rise in hospitals in the United States, and there is only a “limited window of opportunity” to halt their spread, health officials warned Tuesday.

The bacteria, normally found in the gut, have acquired a lethal trait: they are unscathed by antibiotics, including carbapenems, a group of drugs that are generally considered a last resort. When these resistant germs invade parts of the body where they do not belong, like the bloodstream, lungs or urinary tract, the illness may be untreatable. The death rate from bloodstream infections can reach 50 percent.

Dr. Thomas R. Frieden, director of the Centers for Disease Control and Prevention, called the organisms “nightmare bacteria” during a telephone news conference, and noted that they could pass their trait for drug resistance — encoded in a scrap of genetic material called a plasmid — along to other bacteria.

Most people who contract these infections already have other serious illnesses that require complicated treatment and lengthy stays in hospitals, nursing homes or long-term care facilities. One bit of good news, Dr. Frieden said, is that the infections do not seem to have spread beyond hospitals into the community at large. But that could easily happen, he warned.

According to a new report by the disease centers, among all infections with gut bacteria, the proportion caused by carbapenem-resistant types rose to 4 percent in 2012, from 1 percent in 2001; among infections caused by one type of bacteria, Klebsiella, 10 percent have become resistant, compared with 2 percent a decade ago.

Drug-resistant Klebsiella, traced to one patient, caused a notorious outbreak in 2011 at a hospital at the National Institutes of Health. Seventeen other people were infected, and six of them died.

Forty-two states have had cases of carbapenem-resistant infection. The problem is most common in the Northeast, particularly in hospitals in New York City, officials said. Nationwide, about 4 percent of short-stay hospitals reported such infections in the first half of 2012, but the rate was much higher — 18 percent — among long-term acute-care hospitals, which treat people who need ventilators for a long time or who have other chronic problems.

The disease centers recommended a variety of ways to try to stop the infections from spreading. The advice includes the usual call for ruthless scrubbing of all surfaces and relentless handwashing.

But hospitals are also urged to find out whether patients are infected, isolate those who are, and assign dedicated-care teams and equipment to infected people only, to avoid spreading the bacteria to others.

Catheters and intravenous lines should be removed as quickly as possible, because they can be avenues of infection, and doctors should prescribe antibiotics only when they are truly needed. Health officials also urge patients and their loved ones to insist that medical personnel wash their hands before touching a patient.