The U.S. Centers for Disease Control and Prevention (CDC) has released results of research into “unusual resistance” in human pathogens, along with a containment strategy for preventing their spread.
The CDC describes unusual resistance germs as those that are resistant to all or most antibiotics tested, uncommon or carrying special resistance genes and are constantly developing and spreading. Examples include vancomycin-resistant Staphylococcus aureus (VRSA), Candida auris, and certain types of “nightmare bacteria” such as carbapenem-resistant Enterobacteriaceae (CRE).
In its 2017 study, the CDC found 221 instances of unusual resistance genes in “nightmare bacteria.” In screening tests in people with no symptoms, the researchers found a hard-to-treat germ that spreads easily in 11% of test subjects. According to the CDC, more than 23,000 Americans die each year from infections caused by antibiotic-resistant pathogens.
The CDC containment strategy calls for rapid identification of resistance, infection control assessments, testing patients without symptoms who may carry and spread the germ, and continued infection control assessments until spread is stopped. The strategy outlines a coordinated response involving health care facilities, labs, health departments and CDC through the AR (antibiotic resistance) Lab Network.
The strategy offers recommendations for addressing three classes or tiers of antibiotic resistant pathogens. Tier 1 organisms are those with resistance mechanisms new to or rare in the United States, for which no current treatment options exist. Tier 2 organisms are multi-drug-resistant organisms (MDROs) primarily found in healthcare settings but not believed to be found regularly in the region. Tier 3 organisms are MDROs that are already established in the United States and have been identified before in the region but are not thought to be endemic.
According to the report, health departments using the aggressive control strategy have conducted infection control assessments and colonization screenings within 48 hours of finding unusual resistance and have reported no further transmission during follow-up over several weeks.
Read more from the CDC.