Nationally, there's a new buzz about a class of superbug, carbapenem-resistant Enterobacteriaceae, CRE, which is resistant to the strongest antibiotics. It has only been found in hospitals and nursing homes and has no presence in the community, nor is it easily spread from person to person, but the Centers for Disease Control has reported its steady increase.

The buzz is new, but the bug has been around for a decade. Local health systems have taken measures to contain it for several years.

At Sentara, infection control reported that the superbug "has been on the radar since 2006 and was discussed in a case review in 2008 during a Joint Commission survey at Sentara Norfolk General."  

There is no specific screening for this particular bug, but if it shows up in lab tests for other cultures that physicians order, then the patients identified are put on contact precautions, according to Sentara spokesman Dale Gauding.

Contact precautions include patient isolation, wearing gowns and masks, dedicated equipment in the patient room, notification of other departments and hand washing — particularly hand washing.

At Riverside Regional Medical Center, in response to CDC recommendations, the nursing admission risk assessment has added questions about hospitalization outside the United States within the last 6 months and added CRE as a field to the electronic medical records to trigger appropriate precautions, according to Susan D. Moeslein, infection prevention nurse manager. Last week, staff implemented enhanced infection control software to transmit alerts to infection prevention staff and pharmacy staff on "all epidemiologically significant organisms identified in real time."

In a related matter, Sentara is launching a major trial to evaluate the clinical effectiveness of using antimicrobial copper-based hard surfaces and textiles to reduce infections in medical environments. The trial is scheduled to start in April at Sentara Norfolk General. The first "Cupron-enhanced" units — using the patent-pending antimicrobial surfaces and anti-odor textiles for bed linens and patient gowns — are slated to open in late 2013, with more studies planned for Sentara Leigh in Virginia Beach and several long-term care facilities and outpatient centers.