What is the most common setting for acquiring Carbapenem-resistant Enterobacteriaceae (CRE)?

Carbapenem-resistant Enterobacteriaceae (CRE) are a group of bacteria that are resistant to carbapenem antibiotics, which are often used as a last-resort treatment for various infections. The most common setting for acquiring CRE is during hospitalization.

Hospitals provide an environment where patients are at increased risk due to various factors such as invasive devices (like catheters and ventilators), the presence of multiple patients with weakened immune systems, and the widespread use of antibiotics. These conditions allow for the selection and spread of resistant organisms. In addition, hospitals often house populations that have been exposed to different strains of bacteria, including those that are resistant to multiple drugs like CRE.

While long-term care facilities and community healthcare services can also contribute to the spread of resistant organisms, the acute, intensive care environment of hospitals is typically where CRE infections are most frequently acquired and transmitted. Emergency rooms can serve as entry points for infections, but the majority of cases stem from hospitalization and the prolonged exposure associated with inpatient care. Thus, recognizing the hospital as the primary setting is critical for infection control and prevention strategies targeting CRE.