Patients struggling with antibiotic resistant "superbugs" are spreading them between hospitals and nursing homes, according to a new study by Oregon State University, Oregon Health and Science University and the Oregon Health Authority.
Researchers looked at acinetobacter, an opportunistic bacteria that targets patients with compromised immune systems. The strain has a gene which makes it both resistant to antibiotics and relatively easy to track.
By looking at outbreaks in seven different facilities and then comparing them with the transfer history of patients, researchers concluded that a lack of communication between facilities is paving the way for outbreaks.
The bacteria can live for a long time on clothing, door handles and other inanimate objects, said Jon Furuno, an associate professor in the OSU/OHSU College of Pharmacy.
“The environment is increasingly being found to contribute to the transmission of these organisms,” he said.
Furuno said the new report lends credibility to a recent Oregon law that requires written communication between discharging and receiving facilities, anytime a patient with a drug-resistant organism is transferred.
“It just makes sense that you would want to alert a receiving facility if patients have a specific drug-resistant organism,” Furuno said. “The discharging facility needs to include that information with the discharge summary or somewhere on the chart, and the receiving facility needs to know where to look for it.”
Lead author Genevieve Buser is a pediatric infectious disease specialist with the Centers for Disease Control and Prevention Epidemic Intelligence Service.
She said communication can ensure appropriate contact precautions are taken.
“An entire chain of transmission can be prevented if staff at a receiving facility know about a patient’s multidrug-resistant organism status,” Buser said.
Despite problems with bugs being spread between facilities, Oregon is ahead of the curve nationally. Most public health jurisdictions do not require drug-resistant acinetobacter infections to be reported. And clinical laboratories do not generally test for an organism’s underlying genetic resistance mechanisms.
“This outbreak might not have been identified if not for a new, limited, voluntary surveillance system in Oregon and an astute infection preventionist,” Buser said.
Other organizations collaborating on this research included the VA Portland Health Care System; the Division of Infectious Diseases at OHSU; the Oregon State Public Health Laboratory; the Louis Stokes Cleveland VA Medical Center; and Case Western Reserve University.
The CDC and the National Institutes of Health supported the study.
The study’s findings were recently published in the Infection Control & Hospital Epidemiology journal.