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)

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

PROFESSIONAL SOCIETIES

European Society of Clinical Microbiology and Infectious Diseases (ESCMID)

• ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients (ESCMID, 2013)

EU/EEA COUNTRIES

Belgium

• Measures to be applied following the emergence of carbapenemase-producing Enterobacteriaceae in Belgium (High Council for Health, 2011)
  
  French: Mesures à prendre suite à l’émergence des entérobactéries productrices de carbapénémases (CPE) en Belgique (Conseil Supérieur de la Santé, 2011)
   
• Recommendation for the prevention, control and treatment of patients carrying multidrug-resistant bacteria in healthcare settings (MDRO) (High Council for Health, 2019)
  
  French: Recommandations en matière de prévention, maîtrise et prise en charge des patients porteurs de bactéries multi-résistantes aux antibiotiques (MDRO) dans les institutions de soins (Conseil Supérieur de la Santé, 2019)
  
  Dutch: Aanbevelingen inzake preventie, beheersing en aanpak van patiënten die drager zijn van tegen antibiotica multiresistente organismen (MDRO) in zorginstellingen (Hoge Gezondheidsraad, 2019)

Finland

• 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

• 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)

Greece

• Action plan for the management of infections by multidrug-resistant Gram-negative pathogens in healthcare settings (Hellenic Centre for Disease Control and Prevention, 2010)
  Σχέδιο δράσης για την αντιμετώπιση λοιμώξεων από πολυανθκετικά Gram αρνητικά παθογόνα σε χώρους παροχής υπηρεσιών υγείας (Κέντρο Ελέγχου & Πρόληψης Νοσημάτων, 2010)

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)

Ireland

• Guidelines for the Prevention and Control of Multi-drug resistant organisms (MDRO) excluding MRSA in the healthcare setting (Royal College of Physicians / HSE Quality and Safety, 2012 - Updated July 2014)
  (This document includes guidance for infection prevention and control of carbapenem-resistant Enterobacteriaceae)
• Updated Guidelines on Screening for Carriage of Resistant Enterobacteriaceae in Ireland- July 2014 (Royal College of Physicians/HSE Quality and Safety, 2014)
• 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)

Lithuania

• 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

• Guidelines for multidrug-resistant microorganisms (MDRO) (Working Party on Infection Prevention, National Institute for Public Health and the Environment, 2018).
  WIP guideline “Bijzonder resistente micro-organismen (BRMO)” [Ziekenhuizen] (Werkgroep Infectie Preventie, Rijksinstituut voor Volksgezondheid en Milieu, 2018)

Portugal

• 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

• 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)

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

• 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

Sweden

• 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)

COUNTRIES OUTSIDE THE EU/EEA

United Kingdom

• Framework of actions to contain carbapenemase-producing Enterobacterales (UK Health Security Agency, September 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)