Active surveillance for carbapenem resistant enterobacteriaceae (CRE) using stool cultures as a method to decrease...

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Microbiology

Background:

• Carbapenem-Resistant Enterobacteriaceae (CRE) infections are a growing global health concern.
• Limited alternative antibiotics necessitate effective infection transmission prevention strategies.
• Early detection through active surveillance is key to managing CRE.

Purpose of the Study:

• To evaluate the impact of active CRE surveillance on infection rates within a Pediatric Intensive Care Unit (PICU).

Main Methods:

• A retrospective observational study was conducted in a 10-bed PICU from July 2013 to June 2015.
• Rectal swabs were collected for CRE screening in most PICU patients.
• Contact isolation was implemented for patients testing positive for CRE.

Main Results:

• Out of 1022 patients, 1262 rectal swabs were analyzed, revealing a 19.5% CRE colonization rate.
• Following the intervention, ICU-acquired CRE colonization decreased by 36%.
• A 100% reduction in ICU-acquired CRE infections was observed, both statistically significant (p < 0.0001).

Conclusions:

• Active CRE surveillance combined with targeted contact isolation effectively reduces CRE colonization and infection rates in the PICU.
• This approach is vital for controlling CRE spread in critical care settings.