Infection Control

New antibiotic organism elicits CDC recommendations

Briefings on Infection Control, June 1, 2009

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Although much of the focus of MDROs has been on MRSA, a relatively new, and potentially more dangerous, infectious disease has begun to draw attention from IC regulators. Carbapenem-resistant or carbapenemase-producing Enterobacteriaceae (CRE) has recently emerged as the most common gram-negative bacteria and a challenge for physicians all over the world. More specifically, carbapenem-resistant Klebsiella pneumoniae (CRKP) is a species of CRE associated with high morbidity and mortality, prolonged length of stay, and increased cost, according to the March 20 Morbidity and Mortality Weekly Report (MMWR). Doctors in the United States, particularly in New York City and New Jersey, have recently come across this bacterium more frequently. ?I think it?s a new issue,? says Arjun Srinivasan, MD, an epidemiologist in the Division of Healthcare Quality Promotion at the CDC. ?These organisms are not widely encountered. We?ve seen them in isolated examples in at least half the states in the country, but they are not present everywhere and they are not ubiquitous things like C.diff and MRSA. I think, however, there is a rapidly growing awareness of the challenges that these organisms pose, both from an infection control standpoint and from a clinical standpoint.? CRKP has been rapidly growing since 2000, according to the March 20 MMWR. The CDC indicated that 8% of Klebsiella isolates were CRKP, compared to fewer than 1% in 2000, according to the report. The emergence of this infection has prompted officials at the CDC?s Healthcare Infection Control Practices Advisory Committee (HICPAC) to release a new set of guidelines to prevent CRKP.

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