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. 2021 Aug;36(3):175-184.
doi: 10.4266/acc.2021.00409. Epub 2021 Aug 12.

Identification and infection control of carbapenem-resistant Enterobacterales in intensive care units

Jongyoun Yi  1   2 , Kye-Hyung Kim  2   3
Affiliations

Identification and infection control of carbapenem-resistant Enterobacterales in intensive care units

Jongyoun Yi et al. Acute Crit Care. 2021 Aug.

Abstract

Infections with multidrug-resistant organisms among patients in intensive care units (ICUs) are associated with high mortality. Among multidrug-resistant organisms, carbapenem-resistant Enterobacterales (CRE) harbor important pathogens for healthcare-associated infections, including pneumonia, bacteremia, and urinary tract infections. Risk factors for CRE colonization include underlying comorbid conditions, prior antibiotics exposure, prior use of healthcare facilities, device use, and longer ICU stay. The mortality rate due to invasive CRE infection is 22%-49%, and CRE colonization is associated with an approximately 10-fold increased risk of CRE infection. Infection control measures include hand hygiene, contact precautions, minimizing the use of devices, and environmental control. Additionally, implementing active surveillance of CRE carriage should be considered in ICU settings.

Keywords: carbapenem; carbapenem-resistant enterobacteriaceae; drug resistance; infection control; intensive care units.

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Conflict of interest statement

CONFLICT OF INTEREST

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
Suggested preemptive contact precaution and routine surveillance assays to detect carbapenem-resistant Enterobacterales (CRE) in high risk settings.
See this image and copyright information in PMC

References

    1. Fridkin SK, Welbel SF, Weinstein RA. Magnitude and prevention of nosocomial infections in the intensive care unit. Infect Dis Clin North Am. 1997;11:479–96. - PubMed
    1. Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin CD, et al. International study of the prevalence and outcomes of infection in intensive care units. JAMA. 2009;302:2323–9. - PubMed
    1. Hidron AI, Edwards JR, Patel J, Horan TC, Sievert DM, Pollock DA, et al. NHSN annual update: antimicrobial-resistant pathogens associated with healthcare-associated infections: annual summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2006-2007. Infect Control Hosp Epidemiol. 2008;29:996–1011. - PubMed
    1. Centers for Disease Control and Prevention (CDC) Guidance for control of infections with carbapenem-resistant or carbapenemase-producing Enterobacteriaceae in acute care facilities. MMWR Morb Mortal Wkly Rep. 2009;58:256–60. - PubMed
    1. Doi Y. Treatment options for carbapenem-resistant gram-negative bacterial infections. Clin Infect Dis. 2019;69(Suppl 7):S565–75. - PMC - PubMed

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