Carbapenem-resistant Enterobacteriaceae (CRE)
What are CRE?
Carbapenems are a group of antibiotics that are usually used to treat serious infections, and are considered antibiotics of last resort for some infections. Enterobacteriaceae are a family of germs that are found in normal human intestines (gut). Antibiotic resistance happens when antibiotics are no longer effective in killing a germ. CRE are a family of germs that are difficult to treat because they have high levels of resistance to antibiotics. Enterobacteriaceae can be resistant to antibiotics through several different mechanisms. Currently, the most urgent type of CRE is Carbapenemase-producing Carbapenem-resistant Enterobacteriaceae (CP-CRE).
What are CP-CRE?
Carbapenemases are enzymes that break down (inactivate) carbapenem antibiotics. Carbapenemases increasingly have been reported in Enterobacteriaceae in recent years. Common types of carbapenemases are: Klebsiella pneumoniae carbapenemase (KPC), Verona integron-mediated metallo-beta-lactamase (VIM), New Delhi metallo-beta-lactamase (NDM), Imipenemase (IMP), and Oxacillinase-48-like (OXA-48-like). CP-CRE are of increased public health concern due to the mobility of carbapenemases, increased risk of transmission, extensive drug resistance, and increased mortality. Therefore, detection of infected and colonized patients with CP-CRE is important for the prevention and containment of antibiotic resistance.
- Communicable Disease Reporting Rule
- I-NEDSS Case Investigation Form
- Recurrent CP-CRE Case Classification Flowchart
- ISDH Inter-facility Infection Control Transfer Form
- Indianapolis Coalition for Patient Safety (ICPS) CRE Transfer Form
- CDC CRE Toolkit 2015
- AHRQ Carbapenem-Resistant Enterobacteriaceae (CRE) Control and Prevention Toolkit
- CDC Vital Signs March 2013
- CDC CRE webpage
- WHO Guidelines for the Prevention and Control of Carbapenem-Resistant Enterobacteriaceae, Acinetobacter baumannii, and Pseudomonas aeruginosa in Health Care Facilities
Page last updated: October 22, 2018
Page last reviewed: October 22, 2018