Monitoring patients with Carbapenem-resistant Enterobacteriaceae (CRE) is vital to limiting the spread of these deadly bacteria. CRE often are resistant to antibiotics and cause health care-associated infections with high mortality rates.

A recent report from the Centers for Disease Control and Prevention (CDC) outlined cases of patients with CRE that contained plasmid-encoded enzymes. These enzymes inactivate antibiotics and can transfer antibiotic resistance to other bacteria in a patient’s body, allowing for quick transmission between patients.

Containing the spread of CRE is an urgent public health concern, as additional strains of CRE have been found to be resistant to new antibiotics. For example, enterobacteriaceae have recently been found to be newly resistant to the antibiotic colistin in China and ceftazidime-avibactam in the United States. Many cases found in the United States, outlined in the CDC report, are likely tied to international travel and hospitalization. The CDC report recommends considering CRE screening upon admission for patients who recently have been hospitalized abroad.

The CDC previously broadened the scope of its CRE definition in January 2015 to allow for more extensive monitoring, as a step in containing CRE and similar antibiotic bacteria. The CDC also released a toolkit in 2012 to help control the spread of CRE; the toolkit is now undergoing revisions.

Contact Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.