Acute Communicable Disease Control

County of Los Angeles
Department of Public Health
Acute Communicable Disease Control
313 N. Figueroa Street, #212
Los Angeles, CA 90012
Phone: (213) 240-7941
Fax: (213) 482-4856
Email:acdc2@ph.lacounty.gov

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Carbapenem-Resistant Enterobacterales (CRE)

Enterobacterales is a gram-negative bacteria that can cause infections in healthcare settings, including pneumonia, bloodstream infections, wound or surgical site infections, and meningitis. Increasingly, Enterobacterales bacteria have developed antibiotic resistance, most recently to the class of antibiotics known as carbapenems. When bacteria such as Enterobacterales produce an enzyme known as a carbapenemase, they are referred to as carbapenemase producing organisms or carbapenem-resistant Enterobacterales (CRE). This is considered a threat to patient safety because carbapenem antibiotics often are the last line of defense against gram-negative infections that are resistant to other antibiotics.

Reporting Instructions

• LACDPH MDRO Compliance Instructions (4-22-22)
• LACDPH MDRO Reporting FAQ's (7-13-20)
• LACDPH MDRO Reporting Webinar Slides  Recording (2-5-20)

Resources

• ACDC Guidance for the Notification of Patients, Visitors, and Healthcare Personnel Affected by Outbreaks Identified in the Acute Care Hospital Setting
• CDC Travel Alert: Carbapenem-Resistant Pseudomona aeruginosa Infections Following Invasive Medical Procedures in Tijuana, Mexico (1-14-19)
• Health Officer Order for Reporting Carbapenem-Resistant Enterobacteriaceae (CRE) and Antimicrobial Resistance (1-19-17)
• Instructions for Complying with CRE Reporting Requirements (3-15-21)
• Frequently Asked Questions (FAQ) about Reporting CRE (4-5-21)
  
• CRE Case Report Form
  
• Los Angeles County Acute Care Antibiogram Data
  
• Carbapenem-Resistant Enterobacteriaceae Infections Associated with Endoscopic Retrograde Cholangiopancreatography Procedures, Los Angeles County (2015)
• CRE Frequently Asked Questions (FAQ)  English Spanish

For questions, please email us at hai@ph.lacounty.gov

Additional Resources

• CDC: Tracking CRE by Resistance Mechanism Across the US
• Acute Care Hospitals: NHSN CRE Reporting Guidance
• Skilled Nursing Facilities: NHSN CRE Reporting Guidance
• Antimicrobial/Antibiotic Resistance
• Antimicrobial Stewardship
• Population-Based Incidence of Carbapenem-Resistant Klebsiella pneumoniae along the Continuum of Care, LA County
• CDC Klebsiella pneumoniae
• CDC MMWR: Guidance for Control of Infections with Carbapenem-Resistant or Carbapenemase-Producing Enterobacteriaceae in Acute Care Facilities
• Clinical and Laboratory Standards Institute: CDC recommends CLSI Standards for Carbapenem-Resistant or Carbapenemase-Producing Enterobacteriacae