SuperbugDrug-resistant pathogens spread in Florida hospitals

Antibiotic-resistant germs continue to plague hospitals across the United States. In Florida, several hospitals handled antibiotic-resistant germ outbreaks without alerting the public. A Palm Beach Post investigation found that since 2008, twelve outbreaks have affected at least 490 people statewide, and the Florida Department of Health (FDH) did little to inform the public.

The Centers for Disease Control and Prevention (CDC) estimates that drug-resistant germs kill more than 40 percent of individuals with serious infections, and they tend to have a higher kill-rate among patients with weaker immune systems, including the elderly and young children.

In 2008, FDH found that a drug-resistant bacteria had infected ten people in Broward County in a single month, leaving seven of them at one long-term care hospital. The bacteria, now referred to as CRE (Carbapenem-resistant Enterobacteriaceae), had a mortality rate of 69 percent. Officials warned that healthcare professionals must take safety measures to limit the spread of germs from hospitals and nursing homes to the general community. “The speed at which the epidemic…is spreading in our healthcare system mandates urgent action,” said top control experts in a scientific journal.

Five years later, on 4 June 2014, Florida health officials are requiring laboratories to report cases of CRE. CDC director Dr. Tom Frieden has said of CRE, “it can resist all antibiotics, kill a high proportion of people it infects, and spread from person-to-person and bacteria-to-bacteria readily.” Pharmaceutical firms have not invested in a drug to prevent the spread of CRE, so healthcare officials are relying on coordinated prevention measures among area hospitals. “Prevention is the only real option with these germs,” said epidemiologist Dr. L. Silvia Munoz-Price of Jackson Medical Center in Miami. Officials now recommend healthcare workers to practice regular hand-washing, and disinfection of shared medical devices, both of which are standard protocols.

FDH has not released the name of hospitals involved in the twelve CRE outbreaks, and state lawyers have denied public disclosure requests, pointing to an exemption in the open-records law for epidemiological investigations. Hospitals themselves are not motivated to publish that they have highly resistant germs in their facilities, and the state law which requires outbreaks of any germ to be reported have been enforced loosely. In the past five years, Florida’s Agency for Healthcare Administration, which licenses and inspects hospitals, has cited only one hospital for failing to report an outbreak, said agency spokeswoman Shelisha Coleman.

State officials are unaware of how widespread drug-resistant germs are, but a 2011 Duval County Health Department survey found that eight of ten hospitals within the county received reports of 113 CRE cases. Other drug-resistant germs are spreading in Florida’s hospitals, and until now lack of compliance with infection control protocols has made it difficult to reduce the spread.