An escalation in multidrug-resistant (MDR) infections and outbreaks among children in U.S. intensive care units has caused alarm among providers. Bacterial infections, including Enterobacteriaceae, are resistant to numerous drugs and are especially concerning for children, who often have less-developed immune systems and limited options for broad-spectrum antibiotics. Fewer options ultimately equates to an increased risk of death.
In response, healthcare organizations must take greater responsibility in implementing antimicrobial stewardship initiatives and interventions aimed at protecting their most vulnerable populations. Consider that findings from a recent study published in the Journal of the Pediatric Infectious Diseases Society revealed that U.S. children are experiencing more than a 700 percent increase in Enterobacteriaceae-associated infections. This growing issue fuels longer hospital stays and increased mortality risk. Further, many of the pediatric patients studied had already acquired the infection before they were admitted to the hospital, indicating exposure from environmental sources.
Between 2007 and 2015, researchers analyzed data from approximately 94,000 pediatric patients who were diagnosed with Enterobacteriaceae-associated infections throughout 48 children's hospitals across the nation. The study revealed infections caused by antibiotic-resistant bacteria from the Enterobacteriaceae family increased from 0.2 percent in 2007 to 1.5 percent in 2015. Additionally, these patients experienced a 20 percent increase in hospital stays than patients with infections who were not resistant to antibiotics.
The increase in resistant bacteria and the negative impacts on populations span beyond just pediatric patients. According to the Centers for Disease Control and Prevention (CDC), nearly 2 million individuals in the U.S. are impacted each year which contributes to nearly 23,000 mortalities. The CDC also estimates that 20 to 50 percent of all antibiotics prescribed in U.S. acute care hospitals are unnecessary.
In attempt to curb these figures, the Joint Commission now requires hospitals to demonstrate they have antimicrobial resistance programs (ASPs) in place to reduce inappropriate antibiotic prescribing practices and improve the early identification and treatment of infections. In 2016, the Centers for Medicare and Medicaid Services also introduced a proposed rule that would require hospitals to develop and maintain ASPs. ASPs include elements such as appointing leaders responsible for program outcomes, employing clinical infectious diseases pharmacists and monitoring and reporting antibiotic prescribing practices among providers.
A critical component of ASPs is educating the public, patients and other health professionals on antimicrobial stewardship to ensure the highest quality of care, reduce costs, improve health literacy and prevent community-associated infections, such as Enterobacteriaceae.
Prioritizing Clinical Decision Support
To adhere to mandates and lower the rate of antibiotic resistance, healthcare organizations are investing in interventions to reduce length of stay, improve outcomes and prevent unnecessary expenditures. Real-time clinical decision support (CDS) surveillance systems, such as Sentri7®, are increasingly central to effective strategies to streamline processes and maintain successful ASPs.
Sentri7 is built upon evidence-based guidelines and customized rules and alerts to provide clinicians with real-time monitoring of patient medication and culture data. The system is continuously updated with the latest clinical information to help improve antimicrobial prescribing, provide significant return on investment and ensure patients, including those most susceptible to antibiotic-resistant organisms, receive optimal care.