CRE are important for several reasons. First, invasive infections (e.g., bloodstream infections) with CRE are associated with mortality rates exceeding 40% (
5); this is significantly higher than mortality rates observed for carbapenem-susceptible Enterobacteriaceae. Of note, because the majority of positive cultures were from urine, overall in-hospital mortality rates associated with positive cultures were lower in the EIP CRE surveillance (4%). Second, carbapenem-resistant strains frequently possess additional resistance mechanisms that render them resistant to most available antimicrobials; pan-resistant CRE have been reported (
9). Further, novel antimicrobials for multidrug-resistant gram-negative bacilli are in early stages of development and not likely to be available soon (
10). Third,
CRE can spread rapidly in health-care settings (
11,12). Fourth, Enterobacteriaceae are a common cause of community infections, and CRE have the potential to move from their current niche among health-care–exposed patients into the community (
13). Multidrug-resistance is a problem in other gram-negative bacilli such as
Pseudomonas and
Acinetobacter species. However, these organisms are a less common cause of health-care infections and have less potential to spread resistance to other bacteria and into the community (
2).
Originally Posted by dannno
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