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The page below is a sample from the LabCE course Drug-Resistant Superbugs, Multi-drug Resistant Organisms: MRSA, VRE, Clostridium difficile, and CRE. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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CRE Defined and Risk Factors

Carbapenem-resistant Enterobacteriaceae (CRE) are defined by the Center for Disease Control and Prevention (as of January 2015) to include Enterobacteriaceae isolates that are:
  • Resistant to any carbapenem antimicrobial (imipenem*, meropenem, doripenem, or ertapenem)
OR
  • Documented to possess a carbapenemase
*Note that in organisms that are intrinsically nonsusceptible to imipenem (eg, Proteus species), the organism must show resistance to a carbapenem other than imipenem.

CRE risk factors
Healthy individuals do not usually get infections caused by CRE. CRE most commonly causes infections in people who have chronic medical conditions or have a history of taking certain antibiotics for long periods of time. The most prominent risk factor for contracting CRE in the United States is recent or prolonged exposure to hospitals and other healthcare settings (eg, long-term care, nursing homes), particularly when the patient's care requires invasive medical devices like urinary catheters, intravenous catheters, or ventilators.