CPE guidelines galore: ECDC and ACSQH join the party

I recently posted on the WHO CPE guidelines. A couple of people have alerted me to two other recently published guidelines, one from ECDC, and the other from Australian Commission  on Safety and Quality in Healthcare. So, we now have a wealth of guidelines to prevent and control CPE. But how to they compare?

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The prevention paradox: E. coli versus Klebsiella

The prevention paradox, as described in 1981, is the “seemingly contradictory situation where the majority of cases of a disease come from a population at low or moderate risk of that disease, and only a minority of cases come from the high risk population (of the same disease). This is because the number of people at high risk is small”, see. In our world this reflects the question how to prevent transmission of ESBL-producing E. coli (ESBL-EC) or K. pneumoniae (ESBL-KP), or both. A new study may help to decide. Continue reading

WHO guidelines for the prevention and control of carbapenem-resistant organisms

WHO have just released some guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii, and Pseudomonas aerugionsa. This guideline builds on the excellent WHO core components for IPC guidelines.

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Mutational colistin resistance in CPE is the clear and present danger, not plasmid-mediated mcr genes

There has been a lot of concern in scientific journals and the mainstream media about colistin resistance in Enterobacteriaceae caused by plasmid-mediated resistance genes (the mcr genes). However, an article published today by our group suggests that mutational colistin resistance rather than plasmid-mediated mcr genes is a more pressing clinical threat.

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Counting the cost of CPE Mk II

Earlier this year, CMI published our article on the cost of a CPE outbreak in London, which cost 1.1m (Euros) over 10 months. EID have recently published a similar article, reporting a 0.6m (Euro) outbreak of CPE in the Netherlands.

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Looking back on a CPE plasmid attack in the Northwest of England

A genomic study of 44 isolates of CPE from various species identified between 2008 and 2010, mainly from the Northwest of England, has concluded that plasmids played a key role in the early dissemination of CPE.

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How to predict ESBL (part 3)

Six weeks ago I introduced the ESBL-predict study that Tim Deelen from our group coordinates. Every hospital in the world can participate through a user-friendly electronic CRF (in a secured environment). My blog-invitation to particpate worked and some sites already started. In June >1,000 episodes were entered! Here is a short update and info for those that want to join.  Continue reading