8 CRE infection control recommendations from the WHO

The World Health Organization in November published guidelines for the prevention and control of carbapenem-resistant gram-negative bacteria infections in the healthcare setting.

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The guidelines include eight infection control recommendations that apply to carbapenem-resistant Enterobacteriaceae (CRE), Acinetobacter baumannii (CRAB) and Pseudomonas aeruginosa (CRPsA).

Here are the eight recommendations.

1. Infection control programs established to control carbapenem-resistant gram-negative bacteria infections should at minimum include the following: hand hygiene, surveillance (especially for CRE), using precautions such as gloves and gowns, isolating infected patients and conducting regular environmental cleaning.

2. Hand hygiene compliance should be aligned with WHO’s recommendations for optimal hand hygiene, which include washing hands before and after touching the patient, after removing sterile or non-sterile gloves, and before handling an invasive device for patient care, among other guidelines.

3. Healthcare organizations should monitor CRE, CRAB and CRPsA infections. CRE colonization among patients should also be monitored.

4. Contact precautions should be implemented when providing care to patients colonized or infected with to carbapenem-resistant bacteria.

5. Patients colonized or infected with CRE, CRAB or CRPsA should be physically separated from other patients.

6. Multimodal environmental cleaning strategies should be used in rooms housing patients infected or colonized with carbapenem-resistant bacteria.

7. Healthcare organizations should conduct environmental surveillance for CRE, CRAB and CRPsA when deemed epidemiologically viable.

8. Infection control practices should be monitored for efficacy and this information should be disseminated among providers. 

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