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Leaders in infectious disease and infection control, as well as those concerned with patient safety and performance improvement, can use this toolkit to develop interventions to control carbapenem-resistant Enterobacteriaceae (CRE). CRE are the result of a complex family of plasmid-borne resistance factors that circulate among Enterobacteriaceae. In the United States, the overwhelming majority of CRE cases are caused by the plasmid-borne Klebsiella pneumoniae carbapenemase (KPC) gene circulating among Enterobacteriaceae, mostly commonly among Klebsiella pneumoniae isolates. KPC-producing organisms have spread epidemically in the United States and around the world among hospitalized patients.

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