Acute Crit Care.  2021 Aug;36(3):175-184. 10.4266/acc.2021.00409.

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

• Yi J
• Kim KH

• KMID: 2519444
• DOI: http://doi.org/10.4266/acc.2021.00409

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.

Keyword

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

Figure

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

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