Carbapenem-resistant Enterobacterales (CRE)

Agencies

World Health Organization (WHO)

• Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities (2017)

European Centre for Disease Prevention and Control (ECDC)

• Infection prevention and control measures and tools for the prevention of entry of carbapenem-resistant Enterobacteriaceae into healthcare settings: guidance from the European Centre for Disease Prevention and Control (2017)
• Systematic review of the effectiveness of infection control measures to prevent the transmission of carbapenemase-producing Enterobacteriaceae through cross-border transfer of patients (2014)
• Risk assessment on the spread of carbapenemase-producing Enterobacteriaceae (CPE) through patient transfer between healthcare facilities, with special emphasis on cross-border transfer (2011)

US Agency for Healthcare Research and Quality (AHRQ)

• Carbapenem-resistant Enterobacteriaceae (CRE) Control and Prevention Toolkit (2014)

US Centers for Disease Control and Prevention (CDC)

• About Carbapenem-resistant Enterobacterales (2024)
• Facility Guidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE) – November 2015 Update CRE Toolkit

Professional societies

Asia-Pacific Society of Infection Control (APSIC)

• A handbook of Infection Control for the Asian Healthcare Work (2022)

European Society of Clinical Microbiology and Infectious Diseases (ESCMID)

• ESCMID guidelines for the treatment of infections caused by multidrug-resistant Gram-negative bacilli (endorsed by European society of intensive care medicine) (2021)
• ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients (ESCMID, 2013)

International Society for Infectious Diseases (ISID)

• Guide to infection control in the healthcare setting: Carbapenem-resistant Enterobacteriaceae

EU/EEA countries

Austria

• Hygienerichtlinien

Belgium

• MDRO (2022)

Cyprus

• ΠΡΟΛΗΨΗ ΚΑΙ ΕΛΕΓΧΟΣ ΛΟΙΜΩΞΕΩΝ ΠΟΥ ΣΥΝΔΕΟΝΤΑΙ ΜΕ ΚΑΤΑΣΚΕΥΑΣΤΙΚΕΣ ΕΡΓΑΣΙΕΣ ΣΕ ΧΩΡΟΥΣ ΠΑΡΟΧΗΣ ΥΠΗΡΕΣΙΩΝ ΥΓΕΙΑΣ (2024)

Czechia

• No title. Věstník, Vydáno: 9. ŘÍJNA (2012)

Denmark

• Infektionshygiejniske retningslinjer for CPO (2024)
• Vejledning om forebyggelse af spredning af CPO (2018)

Finland

• Ohje moniresistenttien mikrobien tartunnantorjunnasta (2020)
• National guidelines on controlling multidrug-resistant bacteria. (Institute for Health and Wellbeing, 2014) 
  
  Swedish: Anvisning för förebyggande av smittspridning av multiresistenta mikroorganismer : Svensk översättning av originalversion publicerad år 2014 (Institutet för Hälsa och välbefinnandet)
  
  Finnish: Ohje moniresistenttien mikrobien Tartunnantorjunnasta (Terveyden ja hyvinvoinnin laitos, 2014)
  
  (This document includes guidance for infection prevention and control of carbapenem- resistant Enterobacteriaceae)

France

• Actualisation des recommandations relatives à la maîtrise de la diffusion des bactéries hautement résistantes aux antibiotiques émergentes (BHRe) (2020)
• Prevention of cross-transmission of emerging highly resistant bacteria (High Council for Public Health, 2013).
  Prévention de la transmission croisée des 'Bactéries Hautement Résistantes aux antibiotiques émergentes' (BHRe) (Haut Conseil de la Santé Publique, 2013)
  
  (This document includes guidance for infection prevention and control of carbapenem- resistant Enterobacteriaceae)

Germany

• Infection control measures for infections or colonisation by multidrug-resistant Gram-negative bacteria. This document applies to carbapenem-resistant Enterobacteriaceae (Robert Koch Institute, Commission for Hospital Hygiene and Infection Prevention, 2012)
  Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen (Kommission für Kranken-haushygiene und Infektionsprävention beim Robert Koch-Institut, 2012)

Hungary

• Guidance on prevention of infections caused by multi-resistant pathogens(pages 59 and 64) (National Center for Epidemiology, 2016)
  Módszertani levél a multirezisztens kórokozók által okozott fertőzések megelőzéséről (oldalok 59 és 64) (Országos Epidemiológiai Központ, 2016)

Iceland

• Skimun, smitrakning og sýkingavarnir vegna sýklalyfjaónæmra baktería í heilbrigðisþjónustu (2019)

Ireland

• CPE resources
• Key Points from the Guidance relating to Carbapenemase Producing Enterobacterales for Care Facilities for Older People

Italy

• Surveillance and control of infections caused by carbapenemase producing bacteria (CPE) (Ministry of Health, 2013)
  Sorveglianza, e controllo delle infezioni da batteri produttori di carbapenemasi (CPE) (Ministero della Salute, 2013)

Latvia

• Rekomendācijas multirezistentu Gram-negatīvu, t.sk., karbapenemāžu (piem., oxa-48, KPC, NDM u.c.) producējošu baktēriju uzliesmojumu kontrolei un izplatības ierobežošanai slimnīcās (2022)

Lithuania

• Dėl Karbapenemazes gaminančių enterobakterijų plitimo mažinimo tvarkos aprašo patvirtinimo (2024)
• Guidelines to minimise the spread of carbapenem-resistant enterobacteria (Ministry of Health, 2020)
  Karbapenemams atsparių enterobakterijų plitimo mažinimo gairės (Lietuvos Respublikos sveikatos apsaugos ministerija, 2020)

Malta

• Policy for preventing transmission of carbapenem resistant Enterobacteriales (CRE) in non-acute care settings in Malta (including residential, rehabilitation and long-term care institutions) (Infection Prevention and Control, Mater Dei Hospital & Healthcare Standards Directorate, 2019)

Netherlands

• Bijzonder resistente micro-organismen (BRMO) (2024)

Norway

• Karbapenemaseproduserende organismer (CPO) (2025)
• Enterokokkinfeksjon (inkl. vankomycinresistente enterokokker, VRE) – håndbok for helsepersonell (2023)

Portugal

• Norma nº 004/2013 atualizada a 27/07/2022 Vigilância Epidemiológica das Resistências aos Antimicrobianos (2022)
• Recommendation-Prevention of transmission of carbapenem-resistant enterobacteriaceae in acute care hospitals (General Director of Health, 2017)
  Recomendação-Prevenção da transmissão de enterobacteriáceas resistentes aos carbapenemos em hospitais de cuidados de agudos (Direção-Geral da Saúde, 2017)

Poland

• Pałeczki Enterobacterales wytwarzające karbapenemazy (CPE) Epidemiologia, diagnostyka, leczenie i profilaktyka zakażeń (2023)
• Recommendations for the control of sporadic cases and outbreaks caused by Gram negative bacteria of the family Enterobacteriaceae (Polish Ministry of Health, 2012)
  Zalecenia dotyczące postępowania w przypadku zachorowań sporadycznych i ognisk epidemicznych wywołąnych przez Gram ujemne pałeczki z rodziny Enterobacteraceae (Ministerstwo Zdrowia Rzeczypospolitej Polskiej, 2012)
  
  (This document includes guidance for infection prevention and control of carbapenem-resistant Enterobacteriaceae)

Romania

• Ghid privind Enterobacteriaceae producătoare de carbapenemaze: diagnosticul, prevenirea transmiterii interumane și tratamentul infecțiilor produse (2016)

Slovakia

• Guidance for the diagnosis, prevention and control of infections by bacteria with clinically and epidemiologically important resistance mechanisms. (Slovakian Republic Ministry of Health, 2014)
  OU MZ SR pre diagnostiku a protiepidemické opatrenia pri výskyte bakteriálnych pôvodcov infekčných ochorení s klinicky a epidemiologicky významnými mechanizmami rezistencie (Ministerstva zdravotníctva Slovenskej republiky, 2014)
  
  (This document includes guidance for infection prevention and control of carbapenem-resistant Enterobacteriaceae)

Slovenia

• Preprečevanje širjenja bakterij, ki izločajo karbapenemaze v zdravstvenih ustanovah (2023)
• Microbial resistance management strategy (Ministry of Health, Slovenia, 2019)
  Strategija obvladovanje odpornosti mikrobov (Ministrstvo za zdravje, Slovenija, 2019)

Spain

• Plan for the prevention and control against infection with carbapenemase-producing Enterobacteriaceae (Autonomous Community of Madrid, 2013)
  Plan de Prevencion y control frente a la infeccion por enterobacterias productoras de carbapenemasas (EPC) en la Comunidad de Madrid, 2013
• Recomendaciones sobre precauciones estándar y precauciones basadas en la transmisión de microorganismos (2017)

Sweden

• ESBL-carba Anmälningspliktig och smittspårningspliktig sjukdom. (2023)
• ESBL-carba-bildande bakterier (2024)
• ESBL-producing enterobacteria - – Knowledge base with draft notices to limit the spread of Enterobacteriaceae with ESBL. This document applies to carbapenemase-producing Enterobacteriaceae (Public Health Agency of Sweden, 2014)
  ESBL-producerande tarmbakterier – Kunskapsunderlag med förslag till handläggning för att begränsa spridningen av Enterobacteriaceae med ESBL(Folkhälsomyndigheten, 2014)
• Screening för antibiotikaresistenta bakterier – Rapport från en arbetsgrupp med representanter från smittskydd och vårdhygien 2016-2017 (2017)

Countries outside the EU/EEA

Australia

• Recommendations for the control of Multi-drug resistant Gram-negatives: carbapenem resistant Enterobacteriaceae (Australian Commission on Safety and Quality in Healthcare, 2013)

United Kingdom

• Framework of actions to contain carbapenemase-producing Enterobacterales (United Kingdom Health Security Agency, 2022)
• Public Health England.Guidance. Carbapenemase-producing Enterobacteriaceae: early detection, management and control toolkit for acute trusts. Practical advice to prevent or reduce the spread of carbapenemase-producing Enterobacteriaceae in health and residential care settings (2014)
• Public Health England. Guidance: Carbapenemase-producing Enterobacteriaceae: non-acute and community toolkit. Practical advice to prevent or reduce the spread of carbapenemase-producing Enterobacteriaceae (CPE) in community and non-acute healthcare settings (2014)
• Toolkit for the early detection, management and control of carbapenemase-producing Enterobacteriaceae in Scottish acute settings (Health Protection Scotland, 2019)