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Carbapemem-Resistant Enterobacteriaceae: a lethal germ.


The Centers of Disease Control and Prevention (CDC) has identified a potentially fatal antibiotic resistant bacterium which has surfaced in over 200 U.S. hospitals and long-term care facilities. The bacterium named Carbapenem-Resistant Enterobacteriaceae (CRE) has contributed to patient mortality in nearly 50% of individuals which become infected. CRE are in a family of more than 70 bacteria called enterobacteriaceae, including Klebsiella pneumoniae and E. coli, which are typically found in the gastro-intestinal tract.

Who is at risk?

Patients whose care requires devices such as ventilators, urinary catheters, or intravenous catheters, have a prolonged hospital stay, and patients who are taking long courses of certain antibiotics are among those at risk for CRE infections.

Implications for practice:

* The overuse of antibiotics contributes to the development of highly resistant bacteria

* CRE bacteria can transfer their antibiotic resistance to other bacteria of the same type

* Antibiotics are ineffective which leads to potentially untreatable infections

Educate your patients to:

* Inform your healthcare provider if you have been hospitalized in another facility or country

* Take antibiotics only as prescribed

* Ask all healthcare providers to wash their hands with soap and water or an alcohol-based hand rub before and after touching your body

* Clean your own hands often, especially:

** Before preparing or eating food

** Before touching your eyes, nose, or mouth

** Before and after changing wound dressings or bandages or handling medical devices

** After using the bathroom

Recommended best practice:

To reduce spread of CRE bacteria, the CDC requests health-care facilities take the following preventative steps:

* Strictly enforce infection-control precautions

* Cohort patients and segregate equipment after CRE exposure

* Communicate to facilities when patients with CRE are transferred

* Safely prescribe antibiotics

For More Information:

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Title Annotation:One Strong Voice--Clinically Speaking
Publication:Arizona Nurse
Date:May 1, 2013
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