However, the best methods to prevent spread are complex, and multi-faceted and scientific data are still being generated. With few treatment options for patients infected with CRE, infection control to limit spread of these organisms is critical. CRE have demonstrated epidemic potential, spreading rapidly within individual healthcare settings, and across large geographical areas, and are now endemic across the East Coast United States, Israel, Greece, and India/Pakistan. CRE are associated with high morbidity and mortality, with few if any antibiotic treatment options currently and in the near future. Only few antimicrobial agents like colistin, tigecycline, and certain aminoglycosides have consistent in-vitro activity against these carbapenem resistant enterobacteriaceae (CRE), with rising reports of organisms resistant to all available antibiotics. Specifically, this family accounts for 12.4% of catheter-line associated blood stream infections and 12% of all blood stream infections, 34% of all nosocomial urinary tract infections, 18% of surgical site infections, and 23% of ventilator-associated pneumonias. The two most common organisms, Escherichia coli and Klebsiella pneumoniae, account for 15% of all health care infections. Enterobacteriaceae are the most commonly isolated bacteria from clinical specimens (combining inpatient and outpatient specimens) and comprise 21% of all nosocomial isolates in the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) surveillance system in 2006-2007. Other reservoirs include water, plants, soil, and gastrointestinal tract of other animals. coli, Klebsiella sp, Enterobacter sp, Citrobacter sp., Proteus sp., etc) include a large number of gram negative bacilli that are normal colonizers of the human gastrointestinal tract. What are the key principles of preventing gram negative bacteria – Enterobacteriacea?Įnterobacteriaceae (e.g., E.
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