Clinical Edge

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Regional Strategies to Limit Spread of CRE

Am J Infect Control; 2017 Nov 1; Gohil, et al

Regional strategies and interventions to combat the emergence of carbapenem-resistant Enterobacteriaceae (CRE) are essential in limiting spread, with many facilities considering proactive strategies such as chlorhexidine bathing, a recent study found. The study used a 17-question cross-sectional survey administered to infection prevention programs in Orange County, CA, between January and September 2014. Questions addressed newly detected hospital- and community-onset CRE cultures, current CRE control strategies, and support for prevention strategies for a hypothetical regional intervention. Researchers found:

  • Among 31 hospitals, 21 (68%) completed the survey.
  • CRE was hardly detected between 2009-2010; but within 4 years, 90% of hospitals reported CRE, with 2.5-fold higher community-onset than hospital-onset CRE.
  • Between 2011 and 2013, annual CRE incidence increased 4.7-fold.
  • Support for a regional CRE prevention bundle was unanimous.
  • 22% bathed patients positive for CRE with chlorhexidine gluconate and 11% actively screened for CRE; 86% and 57%, respectively, would consider these strategies in a regional intervention.


Gohil SK, Singh R, Chang J, et al. Emergence of carbapenem-resistant Enterobacteriaceae in Orange County, California, and support for early regional strategies to limit spread. Am J Infect Control. 2017;45(11):1177-1182. doi:10.1016/j.ajic.2017.06.004.