Experts from the Oregon State University, the Oregon Health and Science University’s College of Pharmacy and the Oregon Health Authority say that communication breakdowns are among the leading potentials for infection outbreaks of drug-resistant bacteria.
Supported by a slew of organizations, these findings come from a two-year study of Acinetobacter baumannii, a pathogen that largely infects patients with compromised immune systems lodged in health care facilities. For the purposes of the test, experts examined multiple sites throughout the Pacific Northwest, identifying 21 cases. Of those, a majority of 16 contained a rare gene that grants resistance to a class of antibiotics – a gene that can potentially be passed to other organisms. By examining patients’ transfer history, researchers learned the organism spread alongside them, infecting location after location.
A main contributing factor: lack of interfacility communication that patients with the pathogen were even being transferred.
“It just makes sense that you would want to alert a receiving facility if patients have a specific drug-resistant organism,” Jon Furuno, associate professor in the College of Pharmacy and co-author of the study, said. “The discharging facility needs to include that information with the discharge summary or somewhere on the chart, and the receiving facility needs to know where to look for it.”
Such reporting is not required in most U.S. health jurisdictions, nor do clinical laboratories typically test for genetic resistance among such bacteria. While recently enacted Oregon law requires written notification from one facility to another in the case of patient transfers involving multidrug-resistant organisms, or similar infections, it did not come in time to aid these cases.
“An entire chain of transmission can be prevented if staff at a receiving facility know about a patient’s multidrug-resistant organism status,” Genevieve Buser, lead study author and a pediatric infectious disease specialist, said. “This outbreak might not have been identified if not for a new, limited, voluntary surveillance system in Oregon and an astute infection preventionist.”
Both the CDC and the National Institutes of Health supported the study, and its full findings were published in Infection Control and Hospital Epidemiology.