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Health News Florida

'SuperGerm' Outbreaks Kept Quiet

CRE_from_CDC.jpg
CDC
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Lethal forms of antibiotic-resistant bacteria have struck hundreds of patients in a dozen health-care facilities in Florida since 2008,  but state health officials have not required them to share their information and have not alerted the public, the Palm Beach Post reports.

In fact, Post reporter Stacey Singer writes, it took nine months for her  to piece together information on the outbreaks, getting little cooperation from state health agencies. Yet the Centers for Disease Control and Prevention (CDC)'s chief was more than willing to talk about the dangers of carbapenem-resistant Enterobacteriaceae (CRE).

CDC Director Dr. Thomas Frieden called CRE "nightmare bacteria" and said they constitute "one of the most serious health threats we face today," since there is nothing in the pharmaceutical industry pipeline that can control 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," Dr. Frieden told the Post.

CDC says at least 490 patients have become infected in the Florida outbreaks and the mortality rate is at least 40 percent, but the Post says state health officials haven't kept track. 

Of the 12 outbreaks the Post tracked down, the largest one in a hospital setting was at Kindred Hospital Bay Area-St. Petersburg, an extended-care hospital for complex patients, from 2009 to 2011. The Post says 99 of the Kindred patients were infected with CRE plus 16 patients who transferred in. Patients also transferred out of Kindred, spreading the infection to four other hospitals, the Post reports. In December 2010, DOH sent an alert to certain hospital officials, but never made the news public.

Jackson Memorial Hospital in Miami also suffered a CRE outbreak in 2009, but it was held to nine patients, six of whom died, the Post reports.

Another organism that is gaining resistance to carbapenem drugs is Acinobacter baumanii.  Halifax Health Medical Center in Daytona Beach has been battling that for four years, the Post reports, with 125 patients infected. The same germ hit the burn unit at Gainesville's UF Health-Shands Hospital last fall, which caused it to close and undergo redesign, the Post reports.

(The complete list of outbreak sites the Post found is behind a paywall.)

State officials have known of the danger since 2008, when in just a month CRE spread to 10 people in Broward County, seven at the same long-term-care hospital. Top infection control experts around the country called for "urgent action" to prevent its spread to other facilities and to the community outside.

And yet Florida failed even to require laboratories to report CRE until this month. The Post reports that the Agency for Health Care Administration, which regulates hospitals and nursing homes, failed to enforce the law that requires those facilities to report the outbreaks.

Singer reported in the Post that the Department of Health did not respond to her repeated requests to interview its chief, Surgeon General John Armstrong. Instead, she wrote, DOH provided a year-old video press release in which Armstrong said, "While CRE is a serious germ, it is not an imminent threat to our population."

Both DOH and AHCA responded to Singer's record requests by blacking out much of the information that was provided -- the names of the facilities, or in one case, the name of the organism -- citing an exemption in the state's public records laws for information on epidemiology.