More commonly known as CRE, carbapenem-resistant Enterobacteriaceae are bacteria that are located in a person’s gastrointestinal (GI) tract that can cause major infections. Some of these Enterobacteriaceae are resistant to antibiotics, making it harder to eradicate CRE from hospital settings. While they were common in the US before 1992, they have recently become a much bigger problem. Enterobacteriaceae that produce a certain arbapenemase have become a major issue.
CRE can become resistant to carbapenems for a number of reasons. In the past, most CRE were resistant to carbapenems for a number of reasons but recently things have changed. As Klebsiella pneumoniae carbapenemase (KPC) and other carbapenamases have emerged, they have caused CRE to become more resistant. Genes on KPC are very mobile and can be transmitted easily from one bacterium to others very quickly, which causes resistance to spread. This means that more and more bacteria are becoming resistant to the usual treatment types, leaving doctors and other medical care professionals wondering how they will treat these medical problems.
Unfortunately, these Enterobacteriaceae are becoming more and more common in the US. While there isn’t systematic surveillance from the CDC, passive surveillance shows an increase in numbers. This is especially true for people who have been exposed to the bacterium in other countries where it is endemic.
CRE are very important and need to be studied and understood for many reasons. Primarily, these are organisms that are resistant to many types of antibiotics, leaving people wondering how to remove CRE (Carbapenem-resistant Enterobacteriaceae) in health care settings. Additionally, these organisms have very high mortality rates with some studies showing rates of up to 50%. Third, there are many CRE that have carbapenemases that can transmit from one bacterium to another, causing resistance to spread. Finally, infections in healthcare and community settings are often caused by Enterobacteriaceae. If they become resistant to treatment, then this is going to be a major problem as people try to figure out how to kill CRE bacteria.
CRE can either be classified as a colonization or an infection. If there is a colonization, then there is CRE on the body but there is no disease or symptom. They can later cause infections if they are able to enter areas in the body such as the lungs, bladder, or bloodstream. Infections have symptoms that can vary depending on what part of the body was affected.
Anyone who works in healthcare, is in a medical setting for treatment, or is exposed to antimicrobials is at risk for acquisition. Outbreaks are often associated with long-term care, mechanical ventilation, and antimicrobials such as fluoroquinolones and carbapenems.
Medical experts want to prevent the transmission of CRE by identifying cases, placing infected patients in isolated areas, and using antimicrobials carefully.
Infections can occur in almost any part of the body including intra-abdominal abscesses, bloodstream infections, and pneumonia. Most CRE bacterial infections target the urinary tract, specifically in those who have catheters or urinary retention. CRE can kill up to 50% of all people who have bloodstream infections.
Transmission CRE is generally transmitted from one person to another via contaminated equipment or hands. Good hand hygiene and personal protective equipment are both imperative to stop the spread of CRE. When to Stop Isolation The CDC has not made a recommendation on when to stop isolating patients due to CRE. People can actually be colonized by CRE for months at a time, which means that they can still be considered dangerous. Doctors who want to eliminate CRE from nursing homes shouldn’t discontinue isolation based on one negative culture because past studies have shown that CRE may still be present on the patient. Rapidly isolating patients who are colonized or infected is important but so is treating the environment. Using hydroxyl generator air machines from Odorox is a great way to find and eradicate CRE in the environment. They can kill CRE in the air and on surfaces, producing a cleaner and safer hospital, nursing home, or other healthcare area.
To Whom It May Concern:
This past holiday season, I experienced significant smoke damage in my home from an electrical malfunction in my oven, which occurred when running the oven cleaning cycle on a timer in the middle of the nightÑit appeared that the thermostat had stopped working, and the oven temperature just kept rising and rising. When the smoke detectors went off, I wakened and opened my bedroom door on the second floor and saw nothing but smoke in the hallwayÑI could not even see downstairs. There were no flames, just heavy smoke.
The smoke had traveled throughout the first and second floor of my home. A strong odor was detected in the air, and it went into all the closets on both floors, affecting most of the clothing in them. I opened the windows in the home to get cross ventilation and waited outside until sufficient smoke at exited so I could go back into my home. At that point, what remained was a foul odor from the smoke, which was from the protein in the oven as well as some of the plastic surrounding the oven.
The next day, when I went to a meeting, several people in the meeting noticed the smoke odor on my clothing and asked if I had been in a fire. This was an uncomfortable situation to say the least, as I was expecting to host family during the holiday season, not to mention the embarrassment experienced in client meetings. Anxious to remedy the odor problem I contacted Odorox Air Technologies (OAT) in Basking Ridge NJ to see if their Odorox equipment might be able to help my situation.
The guys contacted a local Paul Davis restoration firm, who agreed to operate the Odorox hydroxyl generators at my home to assist in the clean up. Felipe Rodriguez ("Phil") from Paul Davis Restoration & Remodeling followed the instructions given to him by Odorox personnel, and in a matter of just a few days successfully removed the smoke odor from my house (most of it had dissipated after just one day). Paul Davis had installed three of the Odorox machines on the two floors as well as a number of fans to move the air through the house.
Besides the obvious benefit of eliminating the smoke smell, I appreciated not having to leave my home during the clean up processÑthat is because the clean-up process does not use any ozone, which would not have been safe to be around..
It also was interesting to note that the local Maryland Paul Davis folks, having not heard of this hydroxyl technology, were very skeptical of its ability to work. When they came and installed the equipment (shipped to them by Emerald), they said that they could come back the next day with their own equipment to take out the smoke that the Odorox equipment didn't do. When they came back the next day, they were truly amazed at how quickly most of the odors had already been removed much faster than through their more traditional methods they became believers literally overnight. And given that this technology did not require that I vacate my home and dry clean my clothing, treat carpet, etc., they were more than impressed.
Unrelated to the smoke damage, Phil found some mold in my basement (it was from a water leak a few months earlier). I had mentioned that the Odorox equipment could kill the mold spores as well. So once the smoke cleanup was done, and following consultation with the Odorox personnel, I moved one of the Odorox units on the job to my basement to deal with the mold. I am pleased to report the mold is gone with the help of the Odorox and additional clean-up from the restoration crew.
As a business owner and building professional who works with commercial and institutional facilities managers facing odor, mold and other indoor air quality issues threatening their companies, I can say with a great deal of confidence that the Odorox hydroxyl technology will eliminate these types of problems faster and with less disruption and at a lower cost than other previously available means. A big thanks to Odorox!
Peter S. Kimmel, AIA, IFMA Fellow
Dear Odorox Air Technologies,
I would like to thank you for introducing our hotel to your green technology for odor elimination. Traditionally I am very skeptical and not impressed easily when it comes to new technologies that claim to do so many wonderful things. Well, I can tell you that the job your Odorox machines have done removing odor on our smoking floor/hallways, guest rooms, ballrooms, and common areas has made me one of your strongest supporters. We set your machines up in a desired area and go about the rest of our daily duties. When we return a short time later the space smells fresh and revitalized and your Odorox machine is ready for its next challenge.
As the Director of Housekeeping at a very busy Hilton in Parsippany New Jersey I am regularly confronted with various odor challenges. Just recently we started refinishing our bathtubs in all of our guest rooms. We know from past experience that this process can create a strong chemical small that can make our guests and staff uncomfortable. Equipped with your machine I am happy to report these nuisance odors are things of the past.
Keeping our property smelling great is a key component to keeping our customers satisfied with the Hilton experience. I would like to thank Odorox for making my job just a little bit easier.
Head of Housekeeping Services
One Hilton Court, Parsippany, NJ 07054 Direct Line: 973 267 7373
Fax: 973 984 2896
Reservations: www.hilton.com or 1-800-HILTONS
Odorox hydroxyl technology destroys 99.9% of germs, bacteria, mold, mildew, voc's and viruses in the air and on porous and non-porous surfaces which can cause illness and infections. MDU/RX FDA approved and safe to use in spaces occupied by people, pets, and plants.