Interpretation of <i>Standard for Infection Prevention and Control of Carbapenem-resistant Enterobacterales</i>_West China Medical Journal

Authors：

QIAO Fu ^1,2 , CHEN Yi ² ,  ZONG Zhiyong ¹

1. Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Infection Control, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

ZONG Zhiyong, Email: zongzhiy@scu.edu.cn

Keywords：

Carbapenem-resistant Enterobacterales; infection prevention and control; standard; interpretation

DOI：

10.7507/1002-0179.202402116

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

In recent years, the prevalence of carbapenem-resistant Enterobacterales (CRE) has been remarkably increasing. Infections caused by CRE have significantly increased the burden on patients both medically and economically, and the CRE often leads to outbreaks of healthcare-associated infections. It has now become a global public health concern. Consequently, international organizations and academic societies/associations, including the World Health Organization, have developed corresponding prevention and control guidelines. This article provides a detailed introduction to the background, principles, key understandings, and implementation recommendations of China’s Standard for Prevention and Control of Carbapenem-resistant Enterobacterales (WS/T 826－2023). The aim is to enhance the recognition of healthcare workers and medical administrators to prevent and control CRE and to provide detailed technical guidance for healthcare facilities in responding to the spread of CRE, thus ensuring medical quality and patient safety.

Citation： QIAO Fu, CHEN Yi, ZONG Zhiyong. Interpretation of Standard for Infection Prevention and Control of Carbapenem-resistant Enterobacterales. West China Medical Journal, 2024, 39(3): 362-366. doi: 10.7507/1002-0179.202402116 Copy

1.	CHINET 數據云. 細菌分類年份統計. [2024-02-06]. http://www.chinets.com/Data/GermYear.
2.	Huang W, Qiao F, Zhang Y, et al. In-hospital medical costs of infections caused by carbapenem-resistant Klebsiella pneumoniae. Clin Infect Dis, 2018, 67(Suppl_2): S225-S230.
3.	World Health Organization. Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities. Geneva: World Health Organization, 2017.
4.	肖桂榮, 宗志勇. 從《遏制微生物耐藥國家行動計劃(2022-2025 年)》談醫療機構抗微生物藥物管理與微生物耐藥防控. 華西醫學, 2023, 38(3): 321-325.
5.	Campos-Madueno EI, Moradi M, Eddoubaji Y, et al. Intestinal colonization with multidrug-resistant Enterobacterales: screening, epidemiology, clinical impact, and strategies to decolonize carriers. Eur J Clin Microbiol Infect Dis, 2023, 42(3): 229-254.
6.	Halaby T, Al Naiemi N, Beishuizen B, et al. Impact of single room design on the spread of multi-drug resistant bacteria in an intensive care unit. Antimicrob Resist Infect Control, 2017, 6: 117.
7.	Janda JM, Abbott SL. The changing face of the family Enterobacteriaceae (Order: “Enterobacterales”): new members, taxonomic issues, geographic expansion, and new diseases and disease syndromes. Clin Microbiol Rev, 2021, 34(2): e00174-20.
8.	Qiao F, Wei L, Feng Y, et al. Handwashing sink contamination and carbapenem-resistant Klebsiella Infection in the intensive care unit: a prospective multicenter study. Clin Infect Dis, 2020, 71(Suppl 4): S379-S385.
9.	Kotsanas D, Wijesooriya WR, Korman TM, et al. “Down the drain”: carbapenem-resistant bacteria in intensive care unit patients and handwashing sinks. Med J Aust, 2013, 198(5): 267-269.
10.	Valentin AS, Santos SD, Goube F, et al. A prospective multicentre surveillance study to investigate the risk associated with contaminated sinks in the intensive care unit. Clin Microbiol Infect, 2021, 27(9): 1347. e9-1347. e14.
11.	Jamal AJ, Garcia-Jeldes F, Baqi M, et al. Infection prevention and control practices related to carbapenemase-producing Enterobacteriaceae (CPE) in acute-care hospitals in Ontario, Canada. Infect Control Hosp Epidemiol, 2019, 40(9): 1006-1012.
12.	Gestrich SA, Jencson AL, Cadnum JL, et al. A multicenter investigation to characterize the risk for pathogen transmission from healthcare facility sinks. Infect Control Hosp Epidemiol, 2018, 39(12): 1467-1469.
13.	Hota S, Hirji Z, Stockton K, et al. Outbreak of multidrug-resistant Pseudomonas aeruginosa colonization and infection secondary to imperfect intensive care unit room design. Infect Control Hosp Epidemiol, 2009, 30(1): 25-33.
14.	國家衛生和計劃生育委員會規劃與信息司, 中國醫院協會醫院建筑系統研究分會. 綜合醫院建筑設計規范: GB 51039-2014. 北京: 中國計劃出版社, 2014.
15.	重癥監護病房醫院感染預防與控制規范: WS/T 509-2016. 中國感染控制雜志, 2017, 16(2): 191-194.
16.	Warnke P, Pappisch VR, Frickmann H, et al. Influence of bed making on loads of airborne and surface-associated drug-resistant bacteria in patient rooms. J Hosp Infect, 2023, 136: 45-54.
17.	Nelson NM, Aceto A, West GF. New patient privacy curtains to provide passive infection prevention. Infect Prev Pract, 2023, 5(3): 100291.
18.	Shek K, Patidar R, Kohja Z, et al. Rate of contamination of hospital privacy curtains on a burns and plastic surgery ward: a cross-sectional study. J Hosp Infect, 2017, 96(1): 54-58.
19.	Gomides MDA, Fontes AMS, Silveira AOSM, et al. The importance of active surveillance of carbapenem-resistant Enterobacterales (CRE) in colonization rates in critically ill patients. PLoS One, 2022, 17(1): e0262554.
20.	Guo B, Guo Z, Zhang H, et al. Prevalence and risk factors of carbapenem-resistant Enterobacterales positivity by active screening in intensive care units in the Henan Province of China: a multi-center cross-sectional study. Front Microbiol, 2022, 13: 894341.
21.	Chen X, Wen X, Jiang Z, et al. Prevalence and factors associated with carbapenem-resistant Enterobacterales (CRE) infection among hematological malignancies patients with CRE intestinal colonization. Ann Clin Microbiol Antimicrob, 2023, 22(1): 3.
22.	喬甫, 宗志勇. 世界衛生組織《醫療機構耐碳青霉烯的腸桿菌科細菌、銅綠假單胞菌和鮑曼不動桿菌防控指南》介紹. 華西醫學, 2018, 33(3): 259-263.
23.	Reis MAO, de Almeida MCS, Escudero D, et al. Chlorhexidine gluconate bathing of adult patients in intensive care units in S?o Paulo, Brazil: impact on the incidence of healthcare-associated infection. Braz J Infect Dis, 2022, 26(1): 101666.
24.	Abboud CS, de Souza EE, Zandonadi EC, et al. Carbapenem-resistant Enterobacteriaceae on a cardiac surgery intensive care unit: successful measures for infection control. J Hosp Infect, 2016, 94(1): 60-64.
25.	Gall E, Long A, Hall KK. Chlorhexidine bathing strategies for multidrug-resistant organisms: a summary of recent evidence. J Patient Saf, 2020, 16(3S Suppl 1): S16-S22.
26.	Lee JH, Shin J, Park SH, et al. Role of probiotics in preventing carbapenem-resistant Enterobacteriaceae colonization in the intensive care unit: risk factors and microbiome analysis study. Microorganisms, 2023, 11(12): 2970.
27.	中華人民共和國國家衛生和計劃生育委員會. 醫療機構環境表面清潔與消毒管理規范 WS/T 512-2016. 中國感染控制雜志, 2017, 16(4): 388-392.
28.	Liu HL, Liu YL, Sun FY, et al. Hand hygiene among anesthesiologists and microorganisms contamination in anesthesia environments: a single-center observational study. Biomed Environ Sci, 2022, 35(11): 992-1000.
29.	Friedman ND, Carmeli Y, Walton AL, et al. Carbapenem-resistant Enterobacteriaceae: a strategic roadmap for infection control. Infect Control Hosp Epidemiol, 2017, 38(5): 580-594.
30.	俞娟芬, 邢虎, 張德厚, 等. 多部門聯合干預對重癥監護病房多重耐藥菌感染管理的效果研究. 中國消毒學雜志, 2022, 39(1): 58-61.
31.	余淑霞, 路寧維, 許婷, 等. 多部門協作聯合干預 ICU 耐碳青霉烯類鮑氏不動桿菌醫院感染聚集性病例的效果. 中華醫院感染學雜志, 2022, 32(10): 1581-1585.
32.	林秀芳, 賴凌宇. 基于 MDT 與危急值管理在醫院多重耐藥菌醫院感染中的應用. 中國衛生標準管理, 2023, 14(13): 169-173.
33.	莫元春, 李沃田, 楊文, 等. 危急值管理在多重耐藥菌感染控制中的應用. 中華醫院感染學雜志, 2019, 29(10): 1575-1578.

1. CHINET 數據云. 細菌分類年份統計. [2024-02-06]. http://www.chinets.com/Data/GermYear.
2. Huang W, Qiao F, Zhang Y, et al. In-hospital medical costs of infections caused by carbapenem-resistant Klebsiella pneumoniae. Clin Infect Dis, 2018, 67(Suppl_2): S225-S230.
3. World Health Organization. Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities. Geneva: World Health Organization, 2017.
4. 肖桂榮, 宗志勇. 從《遏制微生物耐藥國家行動計劃(2022-2025 年)》談醫療機構抗微生物藥物管理與微生物耐藥防控. 華西醫學, 2023, 38(3): 321-325.
5. Campos-Madueno EI, Moradi M, Eddoubaji Y, et al. Intestinal colonization with multidrug-resistant Enterobacterales: screening, epidemiology, clinical impact, and strategies to decolonize carriers. Eur J Clin Microbiol Infect Dis, 2023, 42(3): 229-254.
6. Halaby T, Al Naiemi N, Beishuizen B, et al. Impact of single room design on the spread of multi-drug resistant bacteria in an intensive care unit. Antimicrob Resist Infect Control, 2017, 6: 117.
7. Janda JM, Abbott SL. The changing face of the family Enterobacteriaceae (Order: “Enterobacterales”): new members, taxonomic issues, geographic expansion, and new diseases and disease syndromes. Clin Microbiol Rev, 2021, 34(2): e00174-20.
8. Qiao F, Wei L, Feng Y, et al. Handwashing sink contamination and carbapenem-resistant Klebsiella Infection in the intensive care unit: a prospective multicenter study. Clin Infect Dis, 2020, 71(Suppl 4): S379-S385.
9. Kotsanas D, Wijesooriya WR, Korman TM, et al. “Down the drain”: carbapenem-resistant bacteria in intensive care unit patients and handwashing sinks. Med J Aust, 2013, 198(5): 267-269.
10. Valentin AS, Santos SD, Goube F, et al. A prospective multicentre surveillance study to investigate the risk associated with contaminated sinks in the intensive care unit. Clin Microbiol Infect, 2021, 27(9): 1347. e9-1347. e14.
11. Jamal AJ, Garcia-Jeldes F, Baqi M, et al. Infection prevention and control practices related to carbapenemase-producing Enterobacteriaceae (CPE) in acute-care hospitals in Ontario, Canada. Infect Control Hosp Epidemiol, 2019, 40(9): 1006-1012.
12. Gestrich SA, Jencson AL, Cadnum JL, et al. A multicenter investigation to characterize the risk for pathogen transmission from healthcare facility sinks. Infect Control Hosp Epidemiol, 2018, 39(12): 1467-1469.
13. Hota S, Hirji Z, Stockton K, et al. Outbreak of multidrug-resistant Pseudomonas aeruginosa colonization and infection secondary to imperfect intensive care unit room design. Infect Control Hosp Epidemiol, 2009, 30(1): 25-33.
14. 國家衛生和計劃生育委員會規劃與信息司, 中國醫院協會醫院建筑系統研究分會. 綜合醫院建筑設計規范: GB 51039-2014. 北京: 中國計劃出版社, 2014.
15. 重癥監護病房醫院感染預防與控制規范: WS/T 509-2016. 中國感染控制雜志, 2017, 16(2): 191-194.
16. Warnke P, Pappisch VR, Frickmann H, et al. Influence of bed making on loads of airborne and surface-associated drug-resistant bacteria in patient rooms. J Hosp Infect, 2023, 136: 45-54.
17. Nelson NM, Aceto A, West GF. New patient privacy curtains to provide passive infection prevention. Infect Prev Pract, 2023, 5(3): 100291.
18. Shek K, Patidar R, Kohja Z, et al. Rate of contamination of hospital privacy curtains on a burns and plastic surgery ward: a cross-sectional study. J Hosp Infect, 2017, 96(1): 54-58.
19. Gomides MDA, Fontes AMS, Silveira AOSM, et al. The importance of active surveillance of carbapenem-resistant Enterobacterales (CRE) in colonization rates in critically ill patients. PLoS One, 2022, 17(1): e0262554.
20. Guo B, Guo Z, Zhang H, et al. Prevalence and risk factors of carbapenem-resistant Enterobacterales positivity by active screening in intensive care units in the Henan Province of China: a multi-center cross-sectional study. Front Microbiol, 2022, 13: 894341.
21. Chen X, Wen X, Jiang Z, et al. Prevalence and factors associated with carbapenem-resistant Enterobacterales (CRE) infection among hematological malignancies patients with CRE intestinal colonization. Ann Clin Microbiol Antimicrob, 2023, 22(1): 3.
22. 喬甫, 宗志勇. 世界衛生組織《醫療機構耐碳青霉烯的腸桿菌科細菌、銅綠假單胞菌和鮑曼不動桿菌防控指南》介紹. 華西醫學, 2018, 33(3): 259-263.
23. Reis MAO, de Almeida MCS, Escudero D, et al. Chlorhexidine gluconate bathing of adult patients in intensive care units in S?o Paulo, Brazil: impact on the incidence of healthcare-associated infection. Braz J Infect Dis, 2022, 26(1): 101666.
24. Abboud CS, de Souza EE, Zandonadi EC, et al. Carbapenem-resistant Enterobacteriaceae on a cardiac surgery intensive care unit: successful measures for infection control. J Hosp Infect, 2016, 94(1): 60-64.
25. Gall E, Long A, Hall KK. Chlorhexidine bathing strategies for multidrug-resistant organisms: a summary of recent evidence. J Patient Saf, 2020, 16(3S Suppl 1): S16-S22.
26. Lee JH, Shin J, Park SH, et al. Role of probiotics in preventing carbapenem-resistant Enterobacteriaceae colonization in the intensive care unit: risk factors and microbiome analysis study. Microorganisms, 2023, 11(12): 2970.
27. 中華人民共和國國家衛生和計劃生育委員會. 醫療機構環境表面清潔與消毒管理規范 WS/T 512-2016. 中國感染控制雜志, 2017, 16(4): 388-392.
28. Liu HL, Liu YL, Sun FY, et al. Hand hygiene among anesthesiologists and microorganisms contamination in anesthesia environments: a single-center observational study. Biomed Environ Sci, 2022, 35(11): 992-1000.
29. Friedman ND, Carmeli Y, Walton AL, et al. Carbapenem-resistant Enterobacteriaceae: a strategic roadmap for infection control. Infect Control Hosp Epidemiol, 2017, 38(5): 580-594.
30. 俞娟芬, 邢虎, 張德厚, 等. 多部門聯合干預對重癥監護病房多重耐藥菌感染管理的效果研究. 中國消毒學雜志, 2022, 39(1): 58-61.
31. 余淑霞, 路寧維, 許婷, 等. 多部門協作聯合干預 ICU 耐碳青霉烯類鮑氏不動桿菌醫院感染聚集性病例的效果. 中華醫院感染學雜志, 2022, 32(10): 1581-1585.
32. 林秀芳, 賴凌宇. 基于 MDT 與危急值管理在醫院多重耐藥菌醫院感染中的應用. 中國衛生標準管理, 2023, 14(13): 169-173.
33. 莫元春, 李沃田, 楊文, 等. 危急值管理在多重耐藥菌感染控制中的應用. 中華醫院感染學雜志, 2019, 29(10): 1575-1578.

West China Medical Journal

Interpretation of Standard for Infection Prevention and Control of Carbapenem-resistant Enterobacterales

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content