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CP-CRE Notification - Memo

Wednesday, January 31, 2018

To:          Infectious Disease Practitioners

               Infection Control Practitioners

From:     Paul A. Granato, Ph.D., Director of Microbiology

               Russell Rawling, MS, M(ASCP)SM, RM (NRM)SM, Manager of Microbiology

Re:         CP-CRE Notification

This notice serves to alert you that the Microbiology department of Laboratory Alliance has recovered three confirmed isolates of carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE) in January of 2018.  Two isolates, Klebsiella pneumoniae and Enterobacter cloacae, were from hospitalized patients’ sputum and wound specimens respectively while the remaining isolate, Citrobacterfreundii, was recovered from an outpatient urine specimen.

All isolates were confirmed as possessing the carbapenemase-resistance gene (KPC) using a rapid, FDA-cleared PCR assay.  The assay can detect five types: KPC, NDM, VIM, OXA-48, and IMP. Also, these same gene resistance markers can be detected in gram-negative rods recovered directly from blood cultures using an alternative molecular assay.

This finding is of significance because the detection of CP-CRE by the Laboratory Alliance Microbiology laboratory is an extremely uncommon finding.  More specifically, only one isolate of CP-CRE: K. pneumoniae Carbapenemase or KPC was detected in the entire 2017 calendar year.

Given this unexpected spike in the detection of CP-CRE, the Microbiology laboratory wants to make you aware of this finding.  The laboratory will continue to provide CRE updates if the situation warrants.

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