A patient is admitted with a urine culture positive for Klebsiella pneumoniae carbapenemase (KPC) — a carbapenem-resistant Enterobacteriaceae (CRE). Which infection prevention and control measures should the nurse implement? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
CRE/KPC requires CONTACT precautions: gown + gloves on every entry, dedicated equipment, hand hygiene with soap and water or alcohol-based rub, often chlorhexidine bathing as part of MDRO bundles, and infection prevention notification with contact tracing. Choice 1 is wrong — CRE colonization and shedding can persist for months after symptoms resolve; isolation discontinuation requires multiple negative surveillance cultures per CDC/facility protocol, not just absence of symptoms.
CRE is one of CDC's "urgent threat" pathogens because of high mortality and limited treatment options (often only colistin, tigecycline, or newer agents like ceftazidime-avibactam). Long-term colonization is the rule, not the exception — so "patient feels better, take off precautions" is a leading source of horizontal transmission in hospitals.
Patient admitted with urinary tract infection; culture positive for KPC-producing Klebsiella pneumoniae — a CRE organism. The hospital classifies CRE as a high-priority multidrug-resistant organism (MDRO).
CRE (Carbapenem-resistant Enterobacteriaceae) — Gram-negative organisms resistant to carbapenems including KPC, NDM, OXA-48, and VIM enzyme producers; CDC urgent threat.
KPC (Klebsiella pneumoniae carbapenemase) — Most common CRE enzyme in the US; hydrolyzes carbapenems; spread by contact with healthcare environments.
Contact precaution bundle — Gown + gloves on entry, dedicated equipment, hand hygiene, chlorhexidine bathing, environmental cleaning emphasis.