Carbapenem-resistant Enterobacterales 감시 배양의 의미와 임상 적용

Abstract

Carbapenem-resistant Enterobacterales (CRE) is an urgent and increasing threat worldwide. It can be spread by contact transmission, causing intra-hospital outbreaks; therefore, screen ing for CRE using surveillance culture is critical. It is essential to identify risk factors for CRE transmission, such as history of antibiotic use, previous bacterial culture results, and invasive catheterization. Subsequently, surveillance cultures should be selectively implemented while maintaining close organizational communication with the surrounding medical facilities. This protocol can be clinically applied at admission for groups at high risk of CRE colonization, then biweekly in special situations such as intensive care unit admission or contact with a patient colonized with carbapenemase-producing Enterobacterales (CPE). In addition, surveil lance culture methods should be selected in a mutually complementary manner according to each institution and laboratory environment. Ultimately, various surveillance culture protocols will be necessary as suitable for individual medical infrastructures, patients, and indications for testing intervals