These and other recommendations for hospitals, long-term acute care facilities, nursing homes, and health departments can be found in a CRE prevention toolkit released by the CDC in 2012. "We’re gratified to see that places that have implemented these tools have seen dramatic reductions in their CRE rates," Dr. Frieden said.
Authors of the report acknowledged at least three limitations of the data. First, they wrote, "antimicrobial susceptibility data reported to NNIS and NHSN were generated at individual institutions rather than [at] a central laboratory, and testing methodologies vary between facilities. Second, susceptibility interpretation is based on the recommended break points used when tested. Although carbapenem break points for Enterobacteriaceae were lowered in 2010 and might have influenced the increase in the percentage of isolates that were carbapenem-resistant, most laboratories would not have incorporated those changes by 2011. Finally, in some instances, complete susceptibility test results, particularly for carbapenems, were not reported to NNIS or NHSN, leading to a subset of isolates that were not included in these analyses."
The researchers reported having no relevant financial disclosures.