Traverse City Record-Eagle

March 24, 2013

Munson ready for superbug

By Anne Stanton astanton@record-eagle.com
Traverse City Record-Eagle

---- — TRAVERSE CITY — A “nightmare” superbug that is impervious to antibiotics has appeared in more than 200 hospitals across the country, but Munson Medical Center and area nursing homes aren’t yet among them.

But Munson Medical Center is ready to respond with strict procedures already in place, said David Martin, an infectious disease specialist and a Munson Medical Center employee.

“Our biggest problem is we don’t have any drugs to treat it with,” Martin said. “So if a patient develops an infection with it, we’ll have a tough time treating it, that’s for sure.”

The Centers for Disease Control recently issued a public warning about Carbapenem-Resistant Enterobacteriaceae (CRE), a family of more than 70 bacteria. In recent years, some strains failed to succumb to last-resort antibiotics known as carbapenems.

“CRE are nightmare bacteria,” said CDC Director Dr. Thomas Frieden in a news release. “Our strongest antibiotics don’t work and patients are left with potentially untreatable infections.”

Munson’s only contact with the bacteria occurred two years ago when its lab isolated a bacterial strain from an outpatient, Martin said.

CRE kills about half the people it infects. It’s not highly contagious — acquired by touch, not through air — and Munson plans to contain it with the same safeguards it uses for MRSA, a more treatable superbug.

Martin said infectious patients are isolated in a private room. Staff and visitors must wear a gown, gloves, and sometimes a mask. Hand washing is a must, and family members are advised to touch the patient only with gloves, and preferably not at all.

“There are unique situations. If we know a patient is terminal, and the spouse is right there. ‘I know I’m taking a risk, but I want to kiss my husband one more time’”, Martin said.

In 2012, Munson treated 408 patients with MRSA; the vast majority carried the infection when admitted, said Diane Barton, director of quality and patient safety.

The hospital screens patients for MRSA – accomplished with a nose swab — who are undergoing orthopedic surgery for a joint replacement.

MRSA also can be problematic in prisons and jails because those with HIV, open wounds, and skin piercings are at higher risk. It’s possible to carry MRSA without showing symptoms.

Grand Traverse County Undersheriff Nate Alger said the jail doesn’t screen for MRSA, but does isolate inmates who have known skin infections.

“If we see something suspicious, it’s referred immediately to medical and the inmate is quarantined until cleared,” Alger said.

The recent CDC report underscores the fact that antibiotics can no longer be relied upon to cure serious and deadly infections, Martin said.

“And the future could look much worse,” he added.

Eighty percent of the antibiotics sold in the U.S. are fed to pigs, cows, chicken and sheep, in large part to promote growth. The jury is still out on livestock use to antibiotic-resistant infections in people. Advocates fear antibiotics get into the water supply from secreted urine and manure, and cite studies that show resistant bacteria contaminates some grocery store meat. Scientists say they need more solid data.

Munson’s pharmacy “got on the bandwagon” five years ago to curb antibiotic use at the hospital. A full-time pharmacist reviews infectious disease cases daily, Martin said.

“If we see things that don’t look right we want to intervene and talk to the physician in charge,” he said.

Unfortunately, doctors can’t look to new antibiotics to solve the problem, at least for now.

“Antibiotics are used for a short course, 10 to 15 days, and there’s not nearly enough profit in it for the pharmaceutical companies” Martin said.