Physical therapists (PTs) and physical therapist assistants (PTAs), especially those who have patients with wounds, are encouraged to take steps to protect their most vulnerable patients from carbapenem-resistant Enterobacteriaceae (CRE), a family of germs that have become difficult to treat because they have high levels of resistance to antibiotics. In addition to patients at high risks, PTs and PTAs should take all necessary precautions to prevent the spread of CRE to healthy individuals.      

According to the Centers for Disease Control and Prevention (CDC), CRE are resistant to all, or nearly all, antibiotics—even the most powerful drugs of last-resort. CRE also have high mortality rates, killing 1 in 2 patients who get bloodstream infections from them. Additionally, CRE easily transfer their antibiotic resistance to other bacteria. For example, carbapenem-resistant klebsiella can spread its drug-destroying properties to a normal E. coli bacteria, which makes the E.coli resistant to antibiotics also. "That could create a nightmare scenario since E. coli is the most common cause of urinary tract infections in healthy people," says CDC.

CRE are usually transmitted person-to-person, often on the hands of health care workers. Currently, almost all CRE infections occur in people receiving significant medical care. However, their ability to spread and their resistance raises the concern that potentially untreatable infections could appear in otherwise healthy people, including health care providers.

CDC's website includes resources for patients, providers, and facilities. The agency's CRE prevention toolkit has in-depth recommendations to control CRE transmission in hospitals, long-term acute care facilities, and nursing homes.

APTA is in the process of updating its Infectious Disease Control webpage to ensure that PTs and PTAs have the information they need to understand their critical role in helping to halt the spread of CRE. Look for a follow-up article in News Now when the webpage is launched.