2012 CRE Toolkit - Guidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE)
Part 2: Regional CRE Prevention
Appendix B: General Approach to Carbapenem-resistant Enterobacteriaceae (CRE) Control in Facilities that Rarely or Have Not Identified CRE
New CRE-colonized or CRE-infected patient identified
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- Notify appropriate personnel (i.e., clinical staff, infection prevention staff)
- Notify public health if indicated
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- Place patient on Contact Precautions in single room (if available)
- Reinforce hand hygiene and use of Contact Precautions on affected ward/unit
- Educate healthcare personnel about preventing CRE transmission
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- Screen epidemiologically-linked patient contacts (e.g., roommates) for CRE with at least stool, rectal, or peri-rectal cultures and/or consider point prevalence survey of affected unit
- Consider preemptive Contact Precautions of these patients pending results of screening cultures
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- If screening cultures or further clinical cultures identify additional CRE-colonized or -infected patients, consider additional surveillance cultures of contacts or point prevalence surveys of affected units (if not already done)
- Consider cohorting patients and staff
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- Ensure if patient transferred within the facility that precautions are continued
- Ensure if patient transferred to another facility CRE information is shared with accepting facility
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