The CDC found more than 200 cases in 2017 of unusual resistance genes in "nightmare bacteria" 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 highly resistant germs that are not yet widespread. However, a variety of these resistant germs can still be detected 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 Enterobacteriaceae "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 resistant to antibiotics, according to the CDC report.
When testing more than 5,000 isolates 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, according to CNN.
Approximately 1 in 10 contacts also tested positive during follow-up screening, "meaning the unusual resistance 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 uninfected 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 indicate the "beginning of an inevitable march upwards."
The CDC is promoting an aggressive "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 effective, the containment strategy can reduce the number of nightmare bacteria 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 support 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 resistance, and validate new tests to identify the latest threats.
Healthcare providers, epidemiologists and infection control staff can place patients with unusual resistance on contact precautions, enhance infection control, work with the health department to screen patients, and continue infection control assessments and colonization screenings until the spread is controlled.