Carbapenem-Resistant Enterobacteriaceae (CRE)

Carbapenem-Resistant Enterobacteriaceae (CRE) are untreatable or difficult to treat multidrug-resistant organisms that have developed high levels of resistance to carbapenems, a class of antibiotics that includes doripenem, ertapenem, imipenem and meropenem. Risk factors for CRE colonization or infection include open wounds, presence of indwelling devices including endotracheal tubes, multiple co-morbidities, and high antimicrobial use. Long-term acute care (LTAC) hospitals have the greatest prevalence of patients with CRE-colonization or infection as a result of receiving and caring for patients who have many CRE risk factors and a history of lengthy hospitalizations.

Multiple clusters and outbreaks of CRE have been increasingly recognized in recent years in Northern California acute and long-term care facilities, including facilities in Alameda County. CRE are highly transmissible in healthcare settings and both infected and colonized patients can serve as reservoirs for transmission. Early recognition and prompt implementation of infection control precautions are critical to control the spread of CRE in our region.

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