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How frequently are hospitalized patients colonized with carbapenem-resistant Enterobacteriaceae (CRE) already on contact precautions for other indications?

Published online by Cambridge University Press:  01 October 2018

Katherine E. Goodman*
Affiliation:
Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
Patricia J. Simner
Affiliation:
Division of Medical Microbiology, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Eili Y. Klein
Affiliation:
Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland The Center for Disease Dynamics, Economics and Policy, Washington, DC
Abida Q. Kazmi
Affiliation:
Division of Medical Microbiology, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
Avinash Gadala
Affiliation:
Department of Hospital Epidemiology and Infection Control, The Johns Hopkins Hospital, Baltimore, Maryland
Clare Rock
Affiliation:
Department of Hospital Epidemiology and Infection Control, The Johns Hopkins Hospital, Baltimore, Maryland Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
Pranita D. Tamma
Affiliation:
Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
Sara E. Cosgrove
Affiliation:
Department of Hospital Epidemiology and Infection Control, The Johns Hopkins Hospital, Baltimore, Maryland Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
Lisa L. Maragakis
Affiliation:
Department of Hospital Epidemiology and Infection Control, The Johns Hopkins Hospital, Baltimore, Maryland Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
Aaron M. Milstone*
Affiliation:
Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland Department of Hospital Epidemiology and Infection Control, The Johns Hopkins Hospital, Baltimore, Maryland Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
for the CDC Prevention Epicenters Program
Affiliation:
Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland Division of Medical Microbiology, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland The Center for Disease Dynamics, Economics and Policy, Washington, DC Department of Hospital Epidemiology and Infection Control, The Johns Hopkins Hospital, Baltimore, Maryland Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
the CDC MIND-Healthcare Program
Affiliation:
Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland Division of Medical Microbiology, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland The Center for Disease Dynamics, Economics and Policy, Washington, DC Department of Hospital Epidemiology and Infection Control, The Johns Hopkins Hospital, Baltimore, Maryland Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
*
Authors for correspondence: Katherine E. Goodman JD, 615 N. Wolfe Street, Baltimore, MD 21205. E-mail: Kgoodma7@jhu.edu. Aaron Milstone MD, MHS, 200 N Wolfe Street, Rubenstein 3141, Baltimore, MD 21287. E-mail: AMilsto1@jhmi.edu
Authors for correspondence: Katherine E. Goodman JD, 615 N. Wolfe Street, Baltimore, MD 21205. E-mail: Kgoodma7@jhu.edu. Aaron Milstone MD, MHS, 200 N Wolfe Street, Rubenstein 3141, Baltimore, MD 21287. E-mail: AMilsto1@jhmi.edu

Abstract

Using samples collected for VRE surveillance, we evaluated unit admission prevalence of carbapenem-resistant Enterobacteriaceae (CRE) perirectal colonization and whether CRE carriers (unknown to staff) were on contact precautions for other indications. CRE colonization at unit admission was infrequent (3.9%). Most CRE carriers were not on contact precautions, representing a reservoir for healthcare-associated CRE transmission.

Type
Concise Communication
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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Footnotes

Cite this article: Goodman KE, et al. (2018). How frequently are hospitalized patients colonized with carbapenem-resistant Enterobacteriaceae (CRE) already on contact precautions for other indications? Infection Control & Hospital Epidemiology 2018, 39, 1491–1493. doi: 10.1017/ice.2018.236

References

1. Antibiotic resistance threats in the United States, 2013. Centers for Disease Control and Prevention website. https://www.cdc.gov/drugresistance/threat-report-2013/index.html. Published 2013. Accessed September 5, 2018.Google Scholar
2. Facility Guidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE)— November 2015 Update CRE Toolkit. Centers for Disease Control and Prevention website. https://www.cdc.gov/hai/organisms/cre/cre-toolkit/index.html. Published 2015. Accessed September 5, 2018.Google Scholar
3. Simner, PJ, Martin, I, Opene, B, Tamma, PD, Carroll, KC, Milstone, AM. Evaluation of multiple methods for the detection of gastrointestinal colonization of carbapenem-resistant organisms from rectal swabs. J Clin Microbiol 2016;54:16641667.Google Scholar
4. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing, 28th ed., Supplement M100S. Wayne, PA: CLSI; 2018.Google Scholar
5. Pierce, VM, Simner, PJ, Lonsway, DR, et al. Modified carbapenem inactivation method for phenotypic detection of carbapenemase production among Enterobacteriaceae. J Clin Microbiol 2017; 55:23212333.Google Scholar
6. Woodworth, KR, Walters, MS, Weiner, LM, et al. Vital signs: containment of novel multidrug-resistant organisms and resistance mechanisms—United States, 20062017. Morb Mortal Wkly Rep 2018; 67: 396401.Google Scholar
7. Logan, LK, Weinstein, RA. The epidemiology of carbapenem-resistant Enterobacteriaceae: the impact and evolution of a global menace. J Infect Dis 2017;215 Suppl 1:S28S36.Google Scholar
8. McKinnell, JA, Miller, LG, Eells, SJ, Cui, E, Huang, SS. A systematic literature review and meta-analysis of factors associated with methicillin-resistant Staphylococcus aureus colonization at time of hospital or intensive care unit admission. Infect Control Hosp Epidemiol 2013; 34:10771086.Google Scholar
9. Simner, PJ, Goodman, KE, Carroll, KC, Harris, AD, Han, JH, Tamma, PD. Using patient risk factors to identify whether carbapenem-resistant Enterobacteriaceae infections are caused by carbapenemase-producing organisms. Open Forum Infect Dis 2018; 5: ofy094ofy094.Google Scholar
10. Goodman, KE, Simner, PJ, Tamma, PD, Milstone, AM. Infection control implications of heterogeneous resistance mechanisms in carbapenem-resistant Enterobacteriaceae (CRE). Expert Rev Anti-infect Ther 2016;14:95108.Google Scholar