Infection prevention and control

Guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities

© World Health Organization 2017

Publication details

Number of pages: 74
Publication date: November 2017
Languages: English
ISBN: 978-92-4-155017-8


Health care-associated infections (HAI) are one of the most common adverse events in care delivery. A large proportion are caused by antibiotic resistant organisms. There is worldwide consensus that urgent action is needed to prevent and control the spread of antibiotic resistant organisms. Effective infection prevention and control (IPC) is the cornerstone of action to combat antimicrobial resistance. This is emphasized by the International Health Regulations (IHR), which identify effective IPC as a key strategy for dealing with public health threats of international concern.

Carbapenem-resistant gram-negative bacteria, namely, carbapenem-resistant Enterobacteriaceae (CRE), Acinetobacter baumannii (CRAB) and Pseudomonas aeruginosa (CRPsA), are an emerging cause of HAI that pose a significant threat to public health. These bacteria are difficult to treat due to high levels of antibiotic resistance and are associated with high mortality. They have the potential for widespread transmission of resistance via mobile genetic elements. For these reasons, it was agreed that a key priority should be the development of WHO guidelines to provide evidence-based recommendations for the early recognition of CRE-CRAB-CRPsA and specific required IPC practices and procedures to effectively prevent their occurrence and control their spread in acute health care facilities. These are the first ever global guidelines for the prevention and control of CRE-CRAB-CRPsA in health care facilities and they include eight recommendations distilled by the world’s leading experts from a review of the latest evidence. They are intended to support IPC improvement at the health care facility and national level, both in the public services and private sector.

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