Screening for carbapenem-resistant Enterobacteriaceae: Who, When, and How?

Virulence. 2017 May 19;8(4):417-426. doi: 10.1080/21505594.2016.1255381. Epub 2016 Nov 4.

Abstract

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.

Keywords: Carbapenemase-producing organisms; carbapenem-resistant Enterobacteriaceae; colonization; screening.

Publication types

  • Review

MeSH terms

  • Carbapenem-Resistant Enterobacteriaceae / isolation & purification*
  • Carrier State / diagnosis*
  • Carrier State / microbiology*
  • Cross Infection / prevention & control*
  • Enterobacteriaceae Infections / diagnosis*
  • Enterobacteriaceae Infections / microbiology*
  • Humans
  • Infection Control / methods
  • Mass Screening / methods*