HLM: Why has it been so difficult to get data? Might hospital officials and physicians be more specific on death certificates?
AS: CRE is not [nationally] a reportable disease. It's not likely that it would appear on a death certificate. It doesn't have its own diagnosis code. In studies with C. diff (Clostridium difficile) or MRSA (methicillin resistant staphylococcus aureus), we are often able to get that information from specific diagnosis codes.
HLM: What other obstacles prevent you from getting more information to bolster your call to action for hospitals and providers to look for CRE?
AS: I don't know I would say we need to bolster a call to action. The fact that these organisms are on the increase, and are incredibly difficult to treat, and are in some cases untreatable by the antibiotics we have available to us, is evidence enough that we need to take action to stop these before they become a bigger problem.
One of the things you're pointing out is that we're working hard to really change peoples' thinking of how we approach these infections. In the past, we've waited until things were a big problem, until there were lots of cases, and it was pervasive and everywhere before we really encourage[d] people to take aggressive action.
We don't think that's the right way to go. The time to take action against these types of very hard to treat resistant pathogens is when they're at what we presume is a very early stage of development, while there's still an opportunity to act aggressively to slow things down or maybe even reverse it, before we see it in more than 4% of hospitals.