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National infection control program reduced CRE prevalence
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An infection control intervention that was implemented nationally reduced the prevalence of carbapenem-resistant Enterobacteriaceae at long-term care facilities in Israel, according to study results published in Infection Control and Hospital Epidemiology.
“As the global threat of [carbapenem-resistant Enterobacteriaceae] continues to rise, there is a need to better control and understand this bacteria,” Debby Ben-David, MD, of the National Center for Infection Control at the Israel Ministry of Health, said in a press release. “Broadening our focus to long-term care facilities made an impact and reduced the prevalence of these infections, demonstrating the need to look beyond acute care hospitals in our infection control interventions.”
Ben-David and colleagues conducted a prospective cohort interventional study that included 13 facilities in Israel. From 2008 to 2011, a multifaceted intervention to limit carbapenem-resistant Enterobacteriaceae (CRE) transmission was implemented. The intervention included site visits to assess infection control policies; weekly reports to assess CRE risk factors; development of national guidelines for CRE control targeted to the long-term care facility setting; and CRE prevalence surveys using rectal swabs.
During the 4-year study, there were 39 site visits conducted and the facilities were scored on infection control policies according to 16 elements. The overall infection control score more than doubled throughout the study. In 2008, the score was 6.8 of 16; in 2010, the score was 11.6; and in 2011, the score was 14.2. The prevalence of CRE carriage decreased from 16.7% in 2008, to 14.1% in 2010 and to 12.5% in 2011.
Among individuals not known to be colonized, the incidence of CRE carriage decreased from 12.1% in 2008, to 9.5% in 2010 and to 7.9% in 2011. Risk factors associated with CRE carriage included type of ward, colonization pressure, length of stay and lower infection control score.
“The demonstrated potential for rapid dissemination of CRE within and between health care facilities, together with high rates of mortality associated with these pathogens and the need for strict compliance to patient population-based carrier isolation guidelines, necessitates a regional or national control program to ensure containment of spread,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
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