Montgomery, NIH Near ‘Superbug’ Agreement

After a fatal “superbug” swept through the National Institutes of Health earlier this year unbeknownst to the public, state and county officials are on the verge of an agreement that will require NIH to report outbreaks of similar hospital-acquired infections, according to Montgomery County's health officer.

Last fall, a drug-resistant strain of Klebsiella pneumoniae spread throughout NIH’s research hospital, infecting 18 people. Twelve of those cases were fatal; seven attributed to Klebsiella.

Federal and state guidelines did not require NIH to report the outbreak, and NIH officials said they chose not to alert the public earlier because healthy people outside the hospital were at little to no risk, The Washington Post reported.

Montgomery County officials didn’t find out for a year, after NIH published an article in a medical journal in August. 

Officials have been working on an agreement for more than a month. County Executive Isiah Leggett and then-Council President Roger Berliner toured the research hospital at NIH with officials from the Montgomery County Department of Health and Human Services and the Maryland Department of Health and Mental Hygiene.

Clinicians from the three agencies will meet Wednesday to work out the technical details of a Memorandum of Understanding that should be signed by the end of the year, according to Dr. Ulder Tillman, the county health officer.

The terms of the agreement will stipulate that NIH notify the county health department directly, rather than the state. NIH will also alert the county when patients have any communicable disease—such as measles—that poses a threat to county residents, according to The Post.

Hospital infections are the 10th leading cause of death in America, Berliner said.

“The public needs to appreciate… there is no public health threat. These are infections which only attack people whose immune system is already severely compromised,” Berliner said. “… It is unreported. … So the broader public policy question is not about NIH; it is about all the rest of our hospitals, quite frankly, because this is endemic in the northeast, it is the norm.”

Data is not available on Klebsiella rates at the county’s five public hospitals, Tillman said.

The Maryland Secretary of Health will issue an executive order “in the near future” that will require regular reporting, so DHMH can track the outbreaks, Tillman said. Federal funding is tied to a hospital’s ability to prevent and control hospital-acquired infections, she said.

“It’s not just our hospitals where this is concerned, but remember that our long-term care facilities, our nursing homes, that are linked also to the hospitals, so there are reservoirs there as well. That’s an even harder situation to address; the resources just aren’t there.”