Detection and Control of Carbapenem-Resistant Enterobacteriaceae

Infections with carbapenem-resistant Enterobacteriaceae (CRE) are an emerging problem in hospitals. Klebsiella pneumoniae is the organism most often implicated in the U.S., and the most common mechanism of resistance is production of the carbapenemase enzyme bla_kpc. The gene encoding this enzyme is carried on a mobile genetic element, so the risk for dissemination is very high. Rapid, accurate detection of carbapenemase-producing Enterobacteriaceae is essential to help limit spread. Unfortunately, CRE that carry bla_kpc can have MICs to the carbapenems that, although elevated, are still below the susceptibility breakpoint; thus, these strains may not be identified during routine testing. The CDC has now released guidance for CRE detection an…