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How Long Does It Take for CRE Results to Come Back from the Lab The laboratory will usually be able to rule out CRE within three days However if CRE is suspected the sample will be sent to a specialist laboratory for more detailed testing These results may take one or two weeks and you will be given your results as soon as they are ready You will stay in an isolation room until the final results are received If you don t have CRE you may be moved out of the room unless there is another reason for staying in isolation If CRE is picked up in the sample you will stay in the isolation room for the duration of your hospital stay to prevent spreading CRE to other patients What If I Am Discharged Home Before the Results Come Back You can go home as soon as your doctor says you are ready You will not have to stay in hospital to wait for your result and your doctor will let you know the result when it is available There is no need to take special precautions at home People in the community are usually fit and healthy so they are less likely than hospital patients to pick up CRE It is always very important to wash your hands carefully after using the toilet and before preparing meals or eating Further information Please do not hesitate to ask the healthcare staff looking after you if you have any questions or if you require more information about CRE Information on hand hygiene infection control and managing superbugs at home is available on www hse ie infectioncontrol INFORMATION ON CRE INFECTION PREVENTION CONTROL TEAM CARBAPENEM RESISTANT ENTEROBACTERALES Beacon Hospital Sandyford Dublin 18 D18 AK68 This leaflet is adapted from the information leaflet produced by the HSE www hse ie August 2022 Version 1 Tel 01 293 6600 www beaconhospital ie

INFORMATION ON CRE CARBAPENEM RESISTANT ENTEROBACTERALES What Is CRE CRE is the shortened term used when referring to Carbapenem Resistant Enterobacteriaceae CRE are bugs bacteria that live in the bowel and that cannot be treated by certain antibiotics known as carbapenem antibiotics In most people CRE bugs are harmless and do not cause infection However if a patient is prone to infection and the infection is caused by CRE it can be difficult to treat because many of the commonly used antibiotics will not work against CRE Can CRE Be Harmful For most patients CRE lives harmlessly in the bowel and does not cause infection this is called colonisation This is because the person s immune system keeps CRE in check in the bowel and prevents it from spreading elsewhere in the body Sometimes however CRE can cause infection in patients for example when they need intensive care or while receiving chemotherapy CRE can cause infections such as kidney infections wound infections or in severe cases blood infection Antibiotics are needed to treat CRE infection Doctors need to know as soon as possible if a patient is carrying CRE so that the most effective antibiotics can be chosen to treat the infection How Do People Get CRE Patients who have already taken lots of antibiotics are more at risk of picking up CRE The reason for this is that the more bugs are exposed to antibiotics the more likely they will develop resistance to that antibiotic so that antibiotic will no longer work against them CRE is more common in certain countries than others if you have been a patient in a hospital abroad in the past year you need to let your doctor know especially if you are being admitted to an Irish hospital so that they can test for CRE CRE is carried by patients healthcare staff or visitors either harmlessly or if they are infected with it it can spread between patients through direct contact with each other or by touching items or surfaces that the person with CRE may have touched such as bed rails toilets or equipment As patients in hospital are much more vulnerable to infection than patients in their own homes special precautions are required to prevent the spread of CRE between patients in the hospital setting What Are the Special Precautions for Patients With CRE Precautions are designed to prevent CRE spreading between patients on the ward Anybody found to have CRE is placed in an isolation room with their own toilet or commode Staff or visitors must wear gloves and aprons before entering the isolation room and before coming into contact with the patient to protect their hands and clothes from CRE Patients staff and visitors must pay special attention to hand hygiene All staff must clean their hands before and after any contact with every patient regardless of whether the patient has CRE or not How Do You Know If a Patient Is Carrying CRE A swab from a patient s back passage is the quickest and easiest way to check for CRE as it is usually detected in the bowel Your nurse will take the swab and send it to the laboratory to be checked for CRE Why Do We Need To Know If A Patient Is Carrying CRE It is very useful to know if a patient is carrying CRE before it makes them sick If it is known beforehand that the patient is carrying CRE then the most effective antibiotics can be chosen early to treat any signs of an infection When staff know that a patient is carrying CRE special precautions can be put in place immediately to stop the CRE spreading to other patients some of whom might be particularly prone to developing infection if they came into contact with CRE Who Should Be Tested for CRE CRE is a very common bug in some countries If you have been admitted to hospital in another country in the past 12 months you should tell your doctor or nurse so that a CRE test can be done Some Irish hospitals have also picked up CRE in patients If you have been admitted to an Irish hospital in the past 12 months you should tell your doctor or nurse Some hospitals may want to perform a CRE test on patients who might be prone to developing infections for example those needing intensive care treatment