Carbapenem-resistant Enterobacteriaceae (CRE) infections are associated with high mortality, primarily due to delays in administration of effective treatment and the limited availability of effective treatment options. New antibiotics capable of replacing carbapenems, a last-line group of antibiotics used to treat patients infected with multidrug-resistant bacteria, are not likely to become available in the near future. Furthermore, CRE are adapted to spread in healthcare settings as well as in the community.
This ECDC risk assessment outlines the current and possible future risks for human health, the potential for spread both in healthcare settings and in the community, and cross-border aspects that must be taken into consideration both in EU/EEA Member States and in third countries. Options for action addressing these areas are presented also presented in this document.
Options to prevent transmission of CRE in hospitals and other healthcare settings include: timely and appropriate laboratory investigation to avoid delay in appropriate treatment, good standard infection control practices, screening of patients considered at high risk of digestive tract carriage of CRE, enhanced control measures in healthcare settings (contact precautions, patient isolation or cohorting, and dedicated nursing) for patients who are CRE-positive, and the development of antimicrobial stewardship programmes.
For related information see ECDC's report on antimicrobial resistance surveillance in Europe 2014 http://ecdc.europa.eu/en/publications/Publications/antimicrobial-resistance-europe-2014.pdf