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To meet the threat of CRE, here are some of the basic measures CDC recommends for health facilities and clinicians:

• Require and strictly enforce CDC guidance for CRE detection, prevention, tracking, and reporting.

• Make sure their lab can accurately identify CRE.

• Understand their prevalence in the facility and in the region

• Identify colonized and infected patients in the facility and ensure precautions are implemented.

• When transferring a patient, require staff to notify the other facility about infections, including CRE.

• Participate in regional and facility-based efforts designed to stop the transmission of these organisms.

• Notify health departments of outbreaks.

Steps clinicians should take

• Know if patients with CRE are hospitalized at your facility, and stay aware of CRE infection rates. Ask if a patient has received medical care somewhere else, including another country.

• Place patients currently or previously colonized or infected with CRE on Contact Precautions. Whenever possible, dedicate rooms, equipment, and staff to CRE patients.

• Wear a gown and gloves when caring for patients with CRE.

• Perform hand hygiene – use alcohol-based hand rub or wash hand with soap and water before and after contact with patient or their environment.

• Alert the receiving facility when you transfer a CRE patient, and find out when a patient with CRE transfers into your facility.

• Make sure labs immediately alert clinical and infection prevention staff when CRE are identified.

• Prescribe and use antibiotics wisely.

• Discontinue devices like urinary catheters as soon as no longer necessary.


1. Centers for Disease Control and Prevention. Healthcare Associated Infections: Facilities/Settings: Carbapenem-resistant Enterobacteriaceae (CRE) Infection: http://1.usa.gov/1DnNH67