Although much of the focus of multidrug-resistant organisms has been on MRSA, a relatively new and potentially more dangerous infectious disease has begun to draw attention from infection control regulators.

Carbapenem-resistant or carbapenemase-producing Enterobacteriaceae (CRE) have recently emerged as the most common gram-negative bacteria and a challenge for healthcare providers worldwide.

More specifically, according to the March 20 Morbidity and Mortality Weekly Report (MMWR), carbapenem-resistant Klebsiella pneumoniae (CRKP) is a species of CRE associated with:

• High morbidity and mortality
• Prolonged length of stay
• Increased cost

Physicians in the United States have come across this bacterium more frequently, particularly in New York City and New Jersey.

“I think it’s a new issue,” says Arjun Srinivasan, MD, an epidemiologist in the Division of Healthcare Quality Promotion at the Centers for Disease Control and Prevention (CDC). “These organisms are not widely encountered. We’ve seen them in isolated examples in at least half the states in the country, but they are not present everywhere and they are not ubiquitous things like C. diff and MRSA. I think, however, there is a rapidly growing awareness of the challenges that these organisms pose both from an infection control standpoint and from a clinical standpoint.”