The Next Public Health Emergency: The Superbug

February 24th, 2015 by Ben Yelin

While the country’s attention has moved beyond last Fall’s Ebola panic, a new public health threat has emerged from a particularly disturbing place: a major U.S. hospital system. The University of California Los Angeles (UCLA) health system notified 179 patients last week that they may have been exposed last fall to Carbapenem-Resistant Enterobacteriaceae (CRE), which is a type of “superbug.” The patients were exposed during certain endoscopic procedures at the Ronald Reagan UCLA Medical Center. The health system confirmed that 7 patients had been infected, and 2 had died as a result of the infection.

A superbug refers to bacteria that have evolved to the point that most antibiotics cannot kill them. This particular superbug, CRE, kills about half of the patients it infects. The reason this deadly strain of bacteria is so prevalent in hospitals is relatively straightforward: hospitals house a lot of sick people with weak immune systems. Without proper precautions, these bacteria can get stuck onto surgical equipment and other materials. Once the bacteria have settled, it is very hard to remove them from any surface. The FDA singled out one particular type of endoscope as posing a greater danger because it is extremely difficult to clean and disinfect.

The outbreak of the superbug underscores a major challenge to our nation’s hospital systems: wide prevalence of hospital-acquired infections. According to the Centers for Disease Control, over 700,000 Americans per year are infected in hospitals, and 75,000 die as a result of these infections. For some perspective, that’s about twice the number of people who die each year in auto accidents. These infections are very expensive to protect against, and require “tedious and time-consuming care” to prevent. The Department of Health and Human Services encourages hospitals, through Medicare funding formulas, to keep infections to a minimum, but obviously the problem still persists on a wide scale.

The CRE superbug, both due to its immunity to antibiotics, and quite frankly, to its ominous sounding name, serves as a particularly scary example of an all-too-common problem—vigilant, rigorous infection control. Large-scale public health scares, like the Ebola one last year, bring needed attention to communicable diseases and the infrastructure needed to address them. If one positive can come from the superbug outbreak at UCLA, it will be the increased attention given to the serious epidemic of hospital-acquired infections and an increased devotion to patient safety.

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