Carbemem-Resistant Enterobacteriaceae: A Lethal Germ

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The Centers of Disease Control and Prevention has identified a potentially fatal antibiotic resistant bacterium which has surfaced in over 200 U.S. hospitals and long-term care facilities. The bacterium named Carbapenem-Resistant Enterobacteriaceae (CRE) has contributed to patient mortality in nearly 50% of individuals which become infected. CRE are in a family of more than 70 bacteria called enterobacteriaceae, including Klebsiella pneumoniae and E. coli, which are typically found in the gastro-intestinal tract.

Who is at risk?
Patients whose care requires devices such as ventilators, urinary catheters, or intravenous catheters, have a prolonged hospital stay, and patients who are taking long courses of certain antibiotics are among those at risk for CRE infections.

Implications for practice:
  • The overuse of antibiotics contributes to the development of highly resistant bacteria
  • CRE bacteria can transfer their antibiotic resistance to other bacteria of the same type
  • Antibiotics are ineffective which leads to potentially untreatable infections
Educate your patients to:
  • Inform your healthcare provider if you have been hospitalized in another facility or country
  • Take antibiotics only as prescribed
  • Ask all healthcare providers towash their hands with soap and water or an alcohol-based hand rub before and after touching your body
  • Clean your own hands often, especially:
  1. Before preparing or eating food
  2. Before touching your eyes, nose, or mouth
  3. Before and after changing wound dressings or bandages or handling medical devices
  4. After using the bathroom
Recommended best practice:
To reduce spread of CRE bacteria, the CDC requests health-care facilities take the following preventative steps:
  • Strictly enforce infection-control precautions
  • Cohort patients and segregate equipment after CRE exposure
  • Communicate to facilities when patients with CRE are transferred
  • Safely prescribe antibiotics
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