Predictors for Rectal Carriage of Carbapenem-Resistant Enterobacteriaceae

Patient selection: A patient with a positive rectal screen for carbapenem-resistant Enterobacteria at the last previous hospital encounter.

Predictors of continued carriage of resistant organisms:

(1) history of prior fluoroquinolone therapy

(2) admission from another hospital or other institution

(3) time interval <= 3 months since the first isolate of a CRE from the patient

If none of these factors are present, then the chances that a screen for CRE will be positive at a hospital admission is 14%. If one or more factors is present then the risk is 50%.

If a patient who is at high risk for CRE needs to be admitted to a hospital:

(1) The patient should be placed in contact isolation.

(2) There should be heightened environmental cleaning.

(3) There should be increased emphasis on hand hygiene in caregivers.