Carbapenem-Resistant Enterobacteriaceae (CRE): Epidemiology, Duration of Carriage, and Progression to Infection in a Large Healthcare System in Miami, FL

Background: Carbapenem-resistant Enterobacteriaceae (CRE) is an urgent public health threat globally. Limited data are available regarding the epidemiology of CRE in South Florida. We describe the epidemiology of CRE within a large public healthcare system in Miami, FL, the experience with an internal registry, active surveillance testing, and the impact of infection prevention practices. Methods: Retrospective cohort study in four hospitals from a large healthcare system in Miami-Dade County, FL from 2012 to 2016. The internal registry included all CRE cases from active surveillance testing from rectal/tracheal screening occurring in the ICUs of two of the hospitals and clinical cultures across the healthcare system. All CRE cases were tagged in the electronic medical record and automatically entered into a platform for automatic infection control surveillance. The system alerted about new cases, readmissions, and transfers. Results: A total of 371 CRE cases were identified. The overall prevalence was 0.077