carbapenem-resistant Enterobacteriaceae (CRE)
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Epidemiology
- cluster of Verona integron-encoded metallo-beta-lactamase- producing carbapenem-resistant Enterobacteriaceae identified by active surveillance (perirectal cultures), Kentucky 2015[3]
- carbapenem-resistant P. aeruginosa from medical tourism (U.S. residents obtaining surgical procedures in Mexico[7]
Pathology
- difficult to eradicate drug-resistant bacteria that contaminates endoscopes used for duododenoscopy (ERCP)*
* the design of the scopes
Laboratory
- Enterobacteriaceae carbapenemase-resistant identified by culture
- carbapenemase resistance gene
- carbapenemase in stool
- carbapenemase in isolate
Complications
- septicemia due to CRE associated with 40-50% mortality
Management
- treatment with ceftolozane tazobactam plus colistin[5][6]
- prevention:
- 48 hour quarantine post decontamination to allow for bacterial cultures before reusing endoscopes
More general terms
Additional terms
References
- ↑ Terhune C Superbug linked to 2 deaths at UCLA hospital; 179 potentially exposed. The Los Angeles Times. Feb 19, 2015
- ↑ FDA MedWatch. Feb 19, 2015 Endoscopic Retrograde Cholangiopancreatography (ERCP) Duodenoscopes: FDA Safety Communication - Design May Impede Effective Cleaning. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm434922.htm
- ↑ Jump up to: 3.0 3.1 3.2 Yaffee AQ, Roser L, Daniels K et al Notes from the Field: Verona Integron-Encoded Metallo-Beta- Lactamase-Producing Carbapenem-Resistant Enterobacteriaceae in a Neonatal and Adult Intensive Care Unit - Kentucky, 2015. MMWR Weekly / February 26, 2016 / 65(7);190 http://www.cdc.gov/mmwr/volumes/65/wr/mm6507a5.htm
- ↑ Centers for Disease Control & Prevention (CDC) Healthcare-associated Infections (HAIs) Facility Guidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE) - November 2015 Update CRE Toolkit. http://www.cdc.gov/hai/organisms/cre/cre-toolkit/
- ↑ Jump up to: 5.0 5.1 Morrill HJ, Pogue JM, Kaye KS, LaPlante KL. Treatment Options for Carbapenem-Resistant Enterobacteriaceae Infections. Open Forum Infect Dis. 2015 May 5;2(2):ofv050. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26125030 Free PMC Article
- ↑ Jump up to: 6.0 6.1 Medical Knowledge Self Assessment Program (MKSAP) 18, American College of Physicians, Philadelphia 2018
- ↑ Jump up to: 7.0 7.1 Kracalik I, Ham C, Smith AR, et al. Verona integron-encoded metallo-beta-lactamase-producing carbapenem-resistant Pseudomonas aeruginosa infections in U.S. residents associated with invasive medical procedures in Mexico, 2015-2018. MMWR Morb Mortal Wkly Rep 2019 May 24; 68:463-464 https://www.cdc.gov/mmwr/volumes/68/wr/mm6820a4.htm