Screening for carbapenem-resistant Enterobacteriaceae: Who, When, and How?
The global spread of carbapenem-resistant Enterobacteriaceae (CRE) has been fostered by the lack of preemptive screening of patients in healthcare facilities that could prevent patient-to-patient transmission. Outbreaks of CRE infections have led some institutions to implement rigorous screening programs, although controlled comparative data are frequently lacking. Resource limitations and uncertainty regarding the optimal approach has kept many facilities from enacting more active routine surveillance policies that could reduce the prevalence of CRE. The ideal population to target for screening, the frequency of testing, and the preferred test method are components of surveillance programs that remain open to debate. This review discusses the rationale for different screening policies in use and the performance characteristics of laboratory methods available to detect CRE carriage.
a Department of Laboratory Medicine , Cleveland Clinic , Cleveland , OH , USA.
Sandra S
SS
Richter
b Division of Infectious Diseases , Assaf Harofeh Medical Center , Zerifin , Israel.|c Sackler School of Medicine , Tel-Aviv University , Tel-Aviv , Israel.
Dror
D
Marchaim
D000073182:Carbapenem-Resistant Enterobacteriaceae / Q000302:isolation & purification*; D002353:Carrier State / Q000175:diagnosis* / Q000382:microbiology*; D003428:Cross Infection / Q000517:prevention & control*; D004756:Enterobacteriaceae Infections / Q000175:diagnosis* / Q000382:microbiology*; D006801:Humans; D017053:Infection Control / Q000379:methods; D008403:Mass Screening / Q000379:methods*
Carbapenemase-producing organisms; carbapenem-resistant Enterobacteriaceae; colonization; screening