Global guidance on carbapenem-resistant bacteria issued by WHO

Carbapenem-resistant gram-negative bacteria, namely, carbapenem-resistant Enterobacteriaceae (CRE), Acinetobacter baumannii (CRAB) and Pseudomonas aeruginosa (CRPsA), are an emerging cause of the health-care acquired infection that pose a significant threat to public health. The first-ever global guidelines for the prevention and control of CRE-CRAB-CRPsA in healthcare facilities were published on 14 November 2017.The WHO has posted the 76-page report that details the recommendations on its website.

The guidelines development group has made eight key recommendations to help facilities better target the three organisms which are:

• Adopt multipart strategies to prevent and control CRE, CRAB, or CRPsA infection or colonization that includes at least hand hygiene, surveillance (especially for CRE), contact precautions, patient isolation (single room or cohorting), and environmental cleaning


• Implement hand hygiene best practices spelled out in earlier WHO guidance


• Conduct surveillance for CRE-CRAB-CRPsA infection and colonization, especially targeting those with previous CRE colonization, contacts of CRE patients, or those with a history of recent hospitalization in CRE-endemic settings


• Implement contact precautions when caring for infected or colonized patients


• Isolate infected or colonized patients, either in a single room or with others who have the same pathogen


• Comply with environmental cleaning protocols in the "patient zone" of infected or colonized patients, though the optimal cleaning agent was not identified


• Take surveillance cultures of the environment to detect contamination


• Monitor the impact of the interventions

The Experts around the world have shown concern over an alarming increase in the incidence and prevalence of carbapenem-resistant gram-negative bacteria, which have caused outbreaks in different regions of the world involving hospitals and long-term care facilities.In addition to causing severe illnesses and deaths, the infections have the potential to trigger outbreaks and fuel the spread of resistance.