I am currently involved in some research that requires a clear distinction between CPE (i.e. Enterobacteriaceae that produce a carbapenemase) and non-carbapenemase-producing CRE. Since ‘non-carbapenemease-producing carbapenem-resistant Enterobacteriaceae’ is a bit of a mouthful, I need to come up with some sort of acronym. I would appreciate your thoughts on the scheme set out below:
You can read more thoughts on acronyms for carbapenem-resistant bacteria in a previous post here.
Reflections on Infection Prevention and Control 
The problem with this simple scheme, Jon, is that you open it with a requirement for carbapenem resistance. This means you immediately ‘lose’ some CPE, those with MICs below the clinical breakpoints (i.e. CPE but non-CRE). I suggest changing the first box to include all strains that match EUCAST’s screening criteria. The EUCAST algorithm starts with ‘Meropenem 0.125 mg/L) in all Enterobacteriaceae’.
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How about ERC (Enterobacteriaceae with Reduced susceptibility to Carbapenems) in place of CRE?!
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I think CPE makes sense this has started to gain traction for one subclass.
Acronyms that are too long become hard to deal with, especially when sharing information with disciplines outside of Infection control. Perhaps the “other” resistance form should be designated ACE where the A stands for “allos” which means other in Greek. This preserves CRE for the general class of both types and prevents misunderstandings when reading older literature on this subject.
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I like the suggested acronyms!
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I am in an organisation recently merged. We are trying to have one term although one uses CPE and another CPO. Our ICD wishes to include non enerobacteriacae and non carbapenemase producing organisms while continuing to highlight organisms that have carbepenem resistance as separate to other MDROs. How do we find a single term to tell clinical staff of the risk? So they manage the patient appropriately? One term nationally so inevitably others wont be in the same position as us, of agreeing the best term for us that puts us different to others? That also is a risk I remember. We are considering CRO – Carbepenem Resistant Organism.
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Hi thanks for the comment. I guess CRO is the only term that would do what you need by the sounds of it. I think there’s a big operational difference between you you’d manage a CPE and an NCP carbapenem-resistant Pseud or Acinetobacter though. So I’d favour CPO if you’re going down the combined route!
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