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Identification and infection control of carbapenem-resistant Enterobacterales in intensive care units
Jongyoun Yi1,2, Kye-Hyung Kim2,3
1Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, Korea.
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.
Insights
Carbapenem-resistant Enterobacterales (CRE) are dangerous multidrug-resistant organisms in ICUs. CRE colonization significantly increases infection risk and mortality, necessitating enhanced infection control and surveillance.
Area of Science:
- Infectious Diseases
- Critical Care Medicine
- Microbiology
Background:
- Multidrug-resistant organisms (MDROs) in intensive care units (ICUs) lead to high mortality.
- Carbapenem-resistant Enterobacterales (CRE) are significant pathogens causing healthcare-associated infections like pneumonia and bacteremia.
Purpose of the Study:
- To highlight the risks and implications of CRE colonization and infection in ICU patients.
- To review risk factors, mortality rates, and effective infection control strategies for CRE.
Main Methods:
- Review of literature on CRE epidemiology, risk factors, and outcomes in ICU settings.
- Analysis of infection control measures and surveillance strategies.
Main Results:
- CRE colonization is linked to a 10-fold increased risk of invasive CRE infection.
- Mortality rates for invasive CRE infections range from 22% to 49%.
- Key risk factors for CRE colonization include comorbidities, prior antibiotic exposure, and longer ICU stays.
Conclusions:
- Effective infection control measures, including hand hygiene and contact precautions, are crucial.
- Active surveillance for CRE carriage in ICUs should be strongly considered to mitigate spread and improve patient outcomes.
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