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Carbapenem-Resistant Enterobacteriaceae: A Call for Cultural ChangeCarbapenem-Resistant Enterobacteriaceae

Tara N. Palmore, MD; and David K. Henderson, MD
[+] Article, Author, and Disclosure Information

From National Institutes of Health Clinical Center, Bethesda, Maryland.

Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-1910.

Requests for Single Reprints: David K. Henderson, MD, National Institutes of Health Clinical Center, Building 10, Room 6-1480, 10 Center Drive, Bethesda, MD 20892; e-mail, dkh@nih.gov.

Current Author Addresses: Dr. Henderson: National Institutes of Health Clinical Center, Building 10, Room 6-1480, 10 Center Drive, Bethesda, MD 20892.

Dr. Palmore: National Institutes of Health Clinical Center, Building 10, Room 12C103A, 10 Center Drive, MSC 1888, Bethesda, MD 20892.

Author Contributions: Conception and design: D.K. Henderson.

Analysis and interpretation of the data: D.K. Henderson.

Drafting of the article: D.K. Henderson.

Critical revision of the article for important intellectual content: T.N. Palmore, D.K. Henderson.

Final approval of the article: T.N. Palmore, D.K. Henderson.

Administrative, technical, or logistic support: D.K. Henderson.

Collection and assembly of data: T.N. Palmore.

Ann Intern Med. 2014;160(8):567-569. doi:10.7326/M13-1910
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Starting in 2011, a cluster of infections caused by carbapenem-resistant Enterobacteriaceae (CRE) occurred at the National Institutes of Health Clinical Center. The authors of this commentary reflect on the experience and discuss ways to manage CRE and other multidrug-resistant organisms.

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impediments to hand washing
Posted on April 14, 2014
John Gullett MD, FACP FIDSA
Conflict of Interest: None Declared
The convenient placement of dispensers has done a great deal to facilitate hand cleansing. Sometimes it still is difficult to find a convenient dispenser.

My estimate is that ten to 15 percent of sinks are obstructed in some way that renders their use for handwashing impractical.

I suggest a concentrated effort to remove obstacles to hand cleansing will improve compliance.

Providers are not the only ones who need to step up to the task. Hospitals do too. Both have done much, yet both can do more.
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