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Carbapenem Resistant Enterobacteriaceae (CRE)

This information describes carbapenem resistant Enterobacteriaceae (CRE), including how it is spread and how infections are treated.

What is carbapenem resistant Enterobacteriaceae?

Carbapenem resistant Enterobacteriaceae (CRE) are a family of germs that are difficult to treat because they have high levels of resistance to antibiotics.

CRE can cause a variety of illnesses, including:

  • Urinary tract infections
  • Pneumonia
  • Blood infections
  • Wound infections

What is the difference between being colonized and being infected with CRE?

A person can be either colonized or infected with CRE. If a person is colonized, it means that the germ is present on their skin or in a body opening, but they have no signs of illness. If a person is infected, it means that the germ is present on their skin or in a body opening and it is causing illness.

How is CRE spread?

Most CRE infections are spread by direct contact with an infected person's bodily fluids (blood, drainage from a wound, urine, stool, or sputum). They can also be spread by contact with equipment or surfaces that have been contaminated with the germ. Casual contact, such as touching or hugging, does not spread CRE.

Who is at risk for a CRE infection?

Healthy people are not at high risk for getting CRE infections. Infections occur more often in people who:

  • Are older
  • Have weakened immune systems
  • Have chronic illnesses
  • Have been treated with antibiotics in the past
  • Had a recent surgery
  • Have had repeated or prolonged hospitalizations
  • Have open wounds or sores
  • Have tubes or drains inserted in the body

What are the symptoms of a CRE infection?

The symptoms vary depending on the location and type of infection.

How is a CRE infection treated?

CRE infections are treated with antibiotics that are not resistant to the germ.

What isolation precautions are taken in the hospital if I have a CRE infection?

  • If you have been diagnosed with a CRE infection, you will be placed in a private room.
  • A sign will be posted on the door instructing all staff and visitors to take precautions.
  • All staff and visitors must clean their hands before going into and after leaving your room. They can use soap and water or an alcohol-based hand sanitizer.
  • All staff and visitors who enter your room must wear a yellow gown and gloves.
  • If you leave your room for tests, you must wear a yellow gown and gloves or be covered with a clean sheet.
  • If you leave your room to walk around the unit, you must wear a yellow gown and gloves.
  • You will not be able to go to the following areas of the hospital:
    • Pantry on your unit
    • Recreation center on M15
    • Pediatric recreation areas on M9
    • Cafeteria
    • Main lobby
    • Any other public area of the hospital
  • While following these isolation precautions, you can have art or massage therapy in your room.
  • These precautions will be discontinued after you have received treatment and no longer have symptoms.

What precautions should I take at home if I have a CRE infection?

Healthy people are not at high risk for getting CRE infections. However, be sure to do the following at home:

  • Wash your hands frequently with soap and water, especially after using the bathroom.
  • Wash your hands after having contact with blood, urine, or drainage from a wound.
  • Use a disinfectant such as Clorox® or Lysol® to wipe any surface that may have been contaminated with the germ.

Where can I get more information about CRE?

If you have any questions, speak with your doctor or nurse. You can also call (212) 639-7814 to speak with a specialist in the Infection Control Department at MSKCC.

You can also visit the following website for more information:

Centers for Disease Control and Prevention