Carbapenem-resistant Klebsiella pneumoniae —impact of infection-prevention and control interventions

Over the last decades, carbapenem-resistant Enterobacteriaceae (CRE) have been increasingly reported from countries all over the world. CRE have emerged as a public health issue reaching a “critical” status according to the “global priority list of antibiotic-resistant bacteria to guide research, discovery and development of new antibiotics” provided by the World Health Organization (WHO) (1). CRE, mainly Klebsiella pneumoniae and Escherichia coli, cause a plethora of healthcare-associated infections, leading to high rates of adverse outcomes among hospitalized patients (2). Attempts to reduce the rapidly increasing incidence of CRE have mainly resulted in recommendations for infection control and prevention measures, active surveillance programs and enhanced antibiotic stewardship, as shown in guidelines provided by the WHO, the European Center for Disease Control (ECDC) and the Centers for Disease Control and Prevention (CDC) (3-5). A recently published systematic review on control of CRE, Acinetobacter baumannii and Pseudomonas aeruginosa in healthcare facilities concluded that multimodal infection control and prevention interventions consisting of three or more components are able to provide highly effective results regarding containment of spread of these pathogens although intervention strategies between the studies were highly variable (6)