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To meet the threat of CRE, here are some of the basic measures CDC recommends for health facilities and clinicians:
• Require and strictly enforce CDC guidance for CRE detection, prevention, tracking, and reporting.
• Make sure their lab can accurately identify CRE.
• Understand their prevalence in the facility and in the region
• Identify colonized and infected patients in the facility and ensure precautions are implemented.
• When transferring a patient, require staff to notify the other facility about infections, including CRE.
• Participate in regional and facility-based efforts designed to stop the transmission of these organisms.
• Notify health departments of outbreaks.
Steps clinicians should take
• Know if patients with CRE are hospitalized at your facility, and stay aware of CRE infection rates. Ask if a patient has received medical care somewhere else, including another country.
• Place patients currently or previously colonized or infected with CRE on Contact Precautions. Whenever possible, dedicate rooms, equipment, and staff to CRE patients.
• Wear a gown and gloves when caring for patients with CRE.
• Perform hand hygiene – use alcohol-based hand rub or wash hand with soap and water before and after contact with patient or their environment.
• Alert the receiving facility when you transfer a CRE patient, and find out when a patient with CRE transfers into your facility.
• Make sure labs immediately alert clinical and infection prevention staff when CRE are identified.
• Prescribe and use antibiotics wisely.
• Discontinue devices like urinary catheters as soon as no longer necessary.
Reference
1. Centers for Disease Control and Prevention. Healthcare Associated Infections: Facilities/Settings: Carbapenem-resistant Enterobacteriaceae (CRE) Infection: http://1.usa.gov/1DnNH67
An absolute most for CRE: Whem transferring a patient notify the other facility about infections
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