Carbapenem-resistant Enterobacteriaceae has increased over the last decade.

In this study of carbapenem-resistant Enterobacteriaceae (CRE) in the United States, the authors described the spread of CRE among acute-care hospitals and estimated the proportion of CRE among Enterobacteriaceae infections. They found that CRE incidence has increased over the last decade.

Data from the National Healthcare Safety Network (NHSN) were used to estimate the percentage of acute-care hospitals reporting at least one CRE infection in 2012. Data from both the NHSN and the National Nosocomial Infection Surveillance system (NNIS), in addition to similar data from the Surveillance Network-USA (TSN), were used to determine the proportion of CRE among all Enterobacteriaceae infections. The authors also used data from the Emerging Infections Program (EIP) to assess the characteristics of CRE infections.

Key Findings:

  • 4.6 percent of acute-care hospitals reported at least one CRE in 2012.
  • The proportion of CRE among all Enterobacteriaceae infections increased from 1.2 percent in 2001 to 4.2 percent in 2011 according to the NNIS and NHSN, and from 0 percent to 1.4 percent according to TSN.
  • Based on EIP data, 92 percent of all CRE infections occurred in patients with health care exposures, especially recent hospitalization.

The authors recommend multi-institutional or even regional approaches to stem the spread of CRE, and suggest that state and local health departments aid surveillance and prevention of CRE.