Top health officials are calling on everyone -- from doctors and nurses to patients and their families -- to help stem the spread of deadly superbugs, which now prey on the sickest people in hospitals and nursing homes but have the potential to sicken much larger numbers of people.
Although many germs have become resistant to antibiotics, from tuberculosis to gonorrhea, health leaders are most concerned about a class of superbugs called carbapenem-resistant Enterobacteriaceae, or CRE.
Because CRE infections can't be treated with modern antibiotics, patients are sometimes being forced to make painful choices to survive.
Neil Fishman, associate chief medical officer at the University of Pennsylvania Health System, says doctors now sometimes resort to old, outdated antibiotics that can damage the kidneys because safer ones no longer work.
"I've had to ask patients, 'Do you want a toxic antibiotic and end up on dialysis, or would you prefer to have a limb amputated?'" Fishman says.
Such dilemmas have led some doctors to believe the world is entering the beginning of a "post-antibiotic era," says Costi Sifri, an infectious-disease physician and hospital epidemiologist at the University of Virginia Health System.
In the first half of 2012, nearly 200 hospitals treated at least one CRE case, says Thomas Frieden, director of the Centers for Disease Control and prevention. About 4% of hospitals have had at least one patient with CRE, the CDC says. These figures could underestimate the scope of the problem, because there is no reliable national data on CRE.
Patients can have trouble finding out if their local hospital has been affected. Only six states require hospitals and other health care facilities to report CRE infections, Frieden says. He outlines a multi-step "Detect and Protect" plan to address the problem:
First, he says, hospitals need to find out which patients have CRE, including those transferred from other facilities. They should take precautions, such as wearing gloves and gowns, to prevent spreading it, even dedicating separate rooms, machines and staff for infected patients.
Hospital staff should remove invasive devices, such as catheters, from patients as soon as possible. The devices can spread the superbug deep into the body, Frieden says. Lastly, doctors need to prescribe antibiotics more judiciously. About half of antibiotic prescriptions are either unnecessary or inappropriate.
"We can't afford to wait until a large-scale outbreak occurs to fight these dangerous bacteria," says Sara Cosgrove, a board member of the Society for Healthcare Epidemiology of America. "Excessive antibiotic use, combined with failure of health care workers to wash hands, allows these bugs to develop and spread."
Patients and their families can help by reminding everyone who enters the hospital room to wash their hands, Frieden says. Patients should speak up if they have recently been in another hospital or foreign country, adds Helen Boucher, a board member of the Infectious Diseases Society of America.
"It's an issue of public health," she says. "We all have to be part of the solution."
To see more of USAToday.com, or to subscribe, go to http://www.usatoday.com
Copyright 2012 USA TODAY, a division of Gannett Co. Inc.