HLM: What do we have in our armamentarium to treat CRE?
AS: Some isolates are susceptible to some antibiotics. But there aren't many antibiotic options and there are limitations to the agents we have available. For example, one is known to be quite a bit more toxic than other agents we would use—that's colistin—and another one has been demonstrated to not be as effective. The treatment options aren't great. Some isolates are in fact resistant to everything we might have to throw at them.
HLM: Is there something health providers need to do to prevent CRE that goes beyond standard precautions?
AS: No. The precautions we recommend for CRE are the same contact precautions. People entering the room need to wear gowns and gloves and wash their hands when they leave the room. What we're encouraging is people to look actively for it, and when you have cases of CRE in your hospital, in some cases we recommend doing screening cultures for patients who might have shared the same physical space (with an infected patient) or had the same healthcare team. Look carefully for CRE and act quickly once you find it.
HLM: But you're not suggesting screening. This is just after you see the first case, right?