Despite the advances of new drugs and the lowering of carbapenem breakpoints to enhance detection of CRE, there should be no complacency about the future of antibacterial therapy. Without effective counter-measures, the prevalence of carriage of carbapenemase-producing organisms (CPOs) and of CPO infections with bad outcomes can be expected to increase. There are three potentially effective counter-measures - the utilization of new anti-CPO antibiotics, antibiotic stewardship, and infection control. Unfortunately, resistance is emerging to the new antibiotics and companies developing them are going bankrupt. There is a lack of convincing evidence about which antibiotic stewardship strategies are effective for countering antibiotic resistance. Therefore, infection control remains the most effective counter-measure. The most crucial components of infection control are effective hand hygiene and rapid CPO detection leading to appropriate interventions that may include surveillance, contact precautions, and disinfection. This presentation focuses on the role of the microbiology laboratory to prevent the spread of carbapenemase-producing organisms or CPOs, with particular emphasis on detection of CPO carriers. Issues addressed will include when, how, and why the laboratory should do tests to detect CPO carriers.

 

At the completion of the session, attendees will be able to understand: