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Hunting for drug-resistant infections in our backyard

August 04, 2015 | John Murray

Susan Huang, MD, MPH

UCI Health infectious diseases specialist Dr. Susan Huang has been on the hunt for antibiotic-resistant infections for most of her career. 

Her goal: identify ways to prevent their spread among patients and healthcare settings. Orange County has proved to be fertile ground, as Huang and her colleagues have conducted numerous studies in dozens of local hospitals and nursing homes where MRSA, methicillin-resistant Staphylococcus aureus, tends to be spread.

Regional monitoring and prevention strategies

Today, much of that research provided the muscle behind the Centers for Disease Control’s call to action to prevent the spread of MRSA and other drug-resistant infections, plus Clostridium difficile, by activating regional monitoring and prevention strategies.

Research by Huang and others clearly show that the movement of patients among healthcare facilities rapidly facilitates the spread of infectious bacteria and requires a coordinated containment response. 

“When it comes to contagious pathogens, no healthcare facility is an island,” Huang said. “Hospitals and nursing homes in the same region should join forces to stop the spread of these pathogens. By investing in joint strategies, we can protect our patients and community from antibiotic-resistant bacteria.”

As CDC director Thomas Frieden said Tuesday:

“National efforts led by federal agencies, healthcare facilities, and public health departments could prevent … an estimated 619,000 drug-resistant and C. difficile infections and saving as many as 37,000 lives over five years. 

A coordinated approach—that is, healthcare facilities and health departments in an area working together—could prevent up to 70 percent of life-threatening carbapenem-resistant Enterobacteriaceae (CRE) infections over five years. Enhanced infection control and improved antibiotic stewardship by an individual facility alone does not have the same impact as facilities across the area working together.”

Federal budget efforts

Frieden and the CDC are encouraging Congress to provide more than $260 million in its next federal budget to fund efforts to coordinate care.

In the meantime, Huang has applied for federal grants to conduct regional interventions in Orange County. If funded, she and her team will coordinate monitoring and prevention efforts across the county’s dozens of health care settings with the support of longstanding collaborators at the Orange County Healthcare Agency and local hospital and nursing home associations.

Huang is professor of medicine and the medical director of epidemiology and infection prevention for UCI Health. Her infection prevention work has helped provide the CDC with ammunition for today’s message.

She has published more than 120 papers focusing on ways to prevent infections from spreading.  In 2013, Huang and colleagues published findings in the New England Journal of Medicine that have lead to improved strategies to more effectively control the spread of MRSA.

Preventing germ spread

The REDUCE MRSA study showed that using germ-killing soap and ointment in hospitals on all intensive care unit patients can reduce bloodstream infections by up to 44 percent and significantly reduce the presence of MRSA. Patients who have MRSA present on their bodies are at increased risk of developing a MRSA infection and can spread the germ to other patients.

Researchers found that this approach was more effective than relying on screening patients for MRSA first, then applying prevention strategies only to those who carry the germ. It was also effective for preventing infections caused by germs other than MRSA.

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