Health & Human services

Examples of Carbapenem-resistant organisms include: 

• Carbapenem-resistant Entereobacterales (CRE): such as Carbapenem-resistant Klebsiella pneumoniae or Carbapenem-resistant E. coli  

• Carbapenem-resistant Acinetobacter baumannii (CRAB) 

• Carbapenem-resistant Pseudomonas aeruginosa (CRPA) 

CROs limits antibiotic treatment options and can cause serious complications and increased mortality. 

CRO Risk and Transmission 

Healthy individuals generally do not get CRO infections. However, individuals that have spent time in healthcare or long-term care facilities are at high-risk for becoming colonized or infected.  

Risk factors for developing CROs include: 

• Being on indwelling medical devices such as medical ventilator, urinary catheters, or endotracheal tubes 

• Recent stay at a ventilator-equipped nursing facility or long-term acute care hospital 

• Overnight stay at a healthcare facility outside of the United States 

CRO are transmitted from person-to-person often through physical contact or medical equipment. Direct person-to-person transmission can occur through contact with an infected persons wounds or stool. Indirect person-to-person contact can occur through contaminated surfaces, as well as contaminated hands or clothing of a healthcare worker. Transmissions can also occur during surgery or through medical treatment devices.  

Prevention  

Several ways to prevent transmission and infection include: 

• Proper hand hygiene practices amongst staff 

• Being aware of new patient admits’ CRO status to ensure precautions in place, and utilizing Interfacility Transfer Communication Form to notify admitting facility of status 

• Coordinating appropriate health response if identification of a single case occurs  

• Utilizing Contact precautions (or enhanced standard precautions for select non-acute care settings) including appropriate use of gowns and gloves upon entry to patients’ rooms and utilizing a private room (or cohorting per the same organism) 

• Taking antibiotics accordingly and when appropriate to specific illness 

Other carbapenemase with mobile genetic elements include: 

• New Delhi Metallo-beta-lactamase (NDM) 

• Verona Integron-Encoded Metallo-beta-lactamase (VIM) 

• Imipenemase (IMP) 

• Oxacillinase-48 (OXA-48)