WHO: Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities
November 16th, 2017Focus on AMR – evidence, guidelines and publications
Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities
The eight recommendations 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
Carbapenem-resistant gram-negative bacteria, namely, carbapenem-resistant Enterobacteriaceae (CRE), Acinetobacter baumannii (CRAB) and Pseudomonas aeruginosa (CRPsA), are an emerging cause of 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 health care facilities were published on 14 November 2017. They include 8 recommendations distilled by the world’s leading experts from a review of the latest evidence. They are designed to provide evidence-based recommendations on the early recognition and specific required infection prevention and control practices (IPC) and procedures to effectively prevent the occurrence and control the spread of CRE-CRAB-CRPsA colonization and/or infection in acute health care facilities. They provide an evidence-based framework to help inform the development and/or strengthening of national and facility IPC policies and programmes to control the transmission of CRE-CRAB-CRPsA in a variety of health care settings. The recommendations included in these guidelines build upon the overarching standards set by the WHO publication Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level.
These guidelines are intended to support IPC improvement at the facility level, targeting infection prevention leads, senior managers, other health care professionals and patients alike. They are also relevant to policy makers, regulatory and professional bodies at the national level, among others. We encourage you all to use and promote these guidelines.