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Rush, Cook County hospitals find success fighting deadly superbug

Saturday, April 25, 2015
Chicago Sun-Times
by Diana Novak Jones

A collaboration between Rush University Medical Center and Cook County health officials has dramatically reduced the spread of the superbug known as CRE, a potentially deadly antibiotic-resistant bacteria.

A cleaning protocol developed by Rush and county researchers to fight CREcarbapenem-resistant enterobacteriaceae — cut the number of cases of the superbug by 50 percent in hospitals where it was tested, according to the Cook County Health and Hospitals System.

Regularly cleaning patients diagnosed with CRE with a special antiseptic wipe and having their doctors wear gowns and gloves during visits reduced the bug’s spread and the risk of infection, said Dr. Robert Weinstein, an infectious disease specialist with the county health system.

CRE typically causes urinary-tract infections but can be deadly if the infection spreads to the bloodstream, killing up to half those infected, according to the federal Centers for Disease Control and Prevention.

Weinstein is the lead principal investigator for the CDC’s Chicago Antimicrobial Resistance and Infection Prevention Epicenter, tasked with developing ways to fight antibiotic-resistant bacteria like MRSA, CRE and C. diff.

CRE is among three antibiotic-resistant bacterial threats the CDC has labeled urgent — its highest ranking. The CDC estimates there are about 9,300 CRE infections in the country a year. A little over 600 of those infected die.

The protocol was tested over three years at four long-term, acute care hospitals, which have higher rates of CRE infection, Weinstein said.

“Long-term acute care centers were disseminating the organism through the community through the transfer of patients,” said Dr. John Jernigan, head of the CDC’s Prevention Epicenters program. “These are very promising and encouraging results that we see.”

The CDC also worked with the Illinois Department of Public Health to put together a database tracking patients diagnosed with CRE, so doctors who treat them are alerted to use extra precautions.

The next step is to determine other health care facilities that could be spreading CRE and test the precautions further, Jernigan said.

“The biggest concern is the lack of antibiotics in the pipeline that would be active against some of these more resistant bugs,” Weinstein said.

“It is resistant of many classes of first-line antibiotics, and it’s growing in incidence,” Jernigan said. “The therapies that are left to us are not optimal. In many cases, we are reaching up and pulling old antibiotics of the shelf that were abandoned before because of toxicities.”

The country’s largest outbreak of CRE was in the Chicago area last year. The CDC identified 44 cases, 38 of them at Advocate Lutheran General Hospital in Park Ridge.

Lutheran General began using a highly toxic gas called EtO to sterilize hard-to-clean instruments in October 2013 and has had no new cases since then.

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