In 2017, the Centers for Disease Control and Prevention (CDC) found 221 instances of “unusual resistance germs” which can cause infections untreatable by antibiotics and spread that resistance to other germs. This “nightmare bacteria,” as the CDC called it, means hospitals and other healthcare facilities need to take “early and aggressive” action whenever a single case is found within their walls.

In a Vital Signs report released on April 3, the CDC said the nationwide lab network set up to help hospitals identify and contain these infections found special genes allowing germs to spread their resistance in 25 percent of the samples it examined. In 10 percent of cases, infected spread the resistant to patients, physicians and nurses who otherwise seemed healthy.

Using these “silent carriers” allows antibiotic-resistant germs to “spread like wildfire,” the CDC said. The quicker they’re discovered, the easier they are to contain.

“With an aggressive response, we have been able to stomp them out promptly and stop their spread between people, between facilities and between other germs,” said Anne Schucat, MD, the CDC’s principal deputy director. “CDC’s containment strategy calls for quickly identifying unusual resistance in patients, assessing infection control and the facility if unusual resistance is found. Sometimes testing contacts of patients with resistance to screen for spread, coordinating with other facilities and continuing infection control screenings until the spread is fully controlled.”

The report offered some examples of when this containment strategy prevented the spread of an unusual antibiotic-resistant germ. In Tennessee, it was identified in a patient who had recently received care in another country by a local health department, but it wasn’t spread after infection control assessments and colonization screenings were performed. In Iowa, five people may have been affected by a germ identified in a nursing home patient with a urinary tract infection, but infection control and contact protocols stopped it from going any further.

For healthcare providers, the CDC emphasized having a plan for when these germs are identified in facilities and knowing some of the basics for addressing the issue, like what isolated samples to send to a lab included in the CDC network. Hospitals and health systems will need to work with local and state health departments to contain the spread with screening, transferring patients and going through infection control assessments.

“A critical role for CDC, state, tribal, and local health agencies is to help providers know how to best provide care based on the current science using antibiotics and the right clinical situations with the right drug at the right dose for the right duration and the right infection control policies and procedures to prevent spread of resistant organisms,” said Jay Butler, MD, chief medical officer of the Alaska Department of Health and Social Services. “We can’t wait until one case becomes ten or ten cases becomes a hundred. We can intervene early and aggressively to stop spread and to keep these threats out of our states.”