Carbapenem-resistant Enterobacteriaceae (CRE)

Carbapenem-resistant Enterobacteriaceae (CRE) are a family of germs that have high levels of resistance to antibiotics and therefore can be difficult to treat.  Examples of Enterobacteriaeceae bacteria that can become carbapenem-resistant are Klebsiella and Escherichia coli (E. coli), which are normal bacteria in the human gut.  Types of CRE include KPC (Klebsiella pneumoniae carbapenemase) and NDM (New Delhi Metallo-beta-lactamase), which are enzymes that break down carbapenem antibiotics and make them ineffective.

Healthy people do not usually get CRE infections.  Patients who are at increased risk for CRE infection include those with ventilators (breathing machines), urine catheters, or intravenous (IV/vein) catheters, or who have been on multiple courses of certain antibiotics

CRE is laboratory reportable in Orange County, effective July 5, 2016.  Laboratory results from specimens sent for diagnostic and screening surveillance purposes that are positive for E. coli, Klebsiella, or Enterobacter species resistant to any carbapenem should be reported to Orange County Epidemiology.  Facilities should forward a list of results every 2 to 4 weeks, according to the process arranged by contacting OCHCA Epidemiology at 714-834-8180.  For more information, see the Health Order Mandating reporting of MRSA, ESBLs, and CRE from Orange County hospitals and skilled nursing facilities.

For more information, see also Healthcare-Associated Infections (HAI).

Last reviewed November 29, 2018