"CRE" Top Priority for Infection Control in Hospitals... 16.9% of Infected Patients Die

KDCA analyzes data from 50,000 patients at 21 hospitals nationwide
CRE has the highest colonization prevalence among major organisms, at 1.79%
Medical costs per infection reach KRW 46 million

Among the major multidrug-resistant organisms found in healthcare facilities, carbapenem-resistant Enterobacterales (CRE) were identified as the highest-priority target for infection control.

The Korea Disease Control and Prevention Agency (KDCA) announced on October 28 the findings of a study conducted with a team led by Professor Song Kyung-ho of the Division of Infectious Diseases at Seoul National University Bundang Hospital. The study analyzed the characteristics of major multidrug-resistant organisms in healthcare facilities and ranked their infection-control priorities.

The research team conducted four point-prevalence surveys between April 2024 and January 2025, covering 49,651 inpatients at 21 hospitals nationwide. The team comprehensively assessed the colonization and infection status of multidrug-resistant organisms, infection severity, length of hospital stay, medical costs, and treatability.

The study found that CRE ranked as the highest-priority target for control. Vancomycin-resistant enterococci (VRE) and multidrug-resistant Acinetobacter baumannii (MRAB) followed, while methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Pseudomonas aeruginosa (MRPA) ranked relatively lower.

Among the organisms studied, CRE had the highest point prevalence of colonization, at 1.79%. It was followed by VRE at 1.73%, MRSA at 1.59%, and MRAB and MRPA at 0.57% each. For actual infections, MRSA had the highest point prevalence at 0.53%, followed by CRE at 0.30%, VRE at 0.23%, MRAB at 0.22%, and MRPA at 0.15%.

The 30-day mortality rate among patients with infections was highest for VRE, at 18.6%, followed by CRE at 16.9%, MRSA at 12.4%, MRAB at 10.9%, and MRPA at 6.5%. The research team noted, however, that it had not separately analyzed the effect of multidrug-resistant infections themselves on mortality, so VRE's control priority may have been overestimated.

The median medical cost per infection was lowest for MRSA, at 29 million won, and highest for VRE, at 59 million won. The figure for CRE was 46 million won. Median hospital stays were 66 days for MRPA and MRAB each, 60 days for CRE, 58 days for VRE, and 44 days for MRSA.

The study also found differences in the level of infection control among healthcare facilities. All 21 hospitals surveyed had infectious disease specialists, but only one had a physician dedicated specifically to infection control. While all hospitals isolated patients with carbapenemase-producing CRE (CP-CRE), only eight isolated patients with MRSA. Only one facility had dedicated personnel for environmental control of multidrug-resistant organisms.

The KDCA plans to continue its efforts to reduce CRE infections and its healthcare-associated infection management program using regional healthcare networks, based on the study's findings. In particular, it plans to strengthen support for early CRE screening, isolation, and environmental control, and to increase the number of infection-control personnel.

Professor Song said, "This survey allowed us to confirm, using objective data, the clinical and socioeconomic burden of multidrug-resistant organisms, including high colonization, infection, and mortality rates, as well as a low rate of clearance from management. There is an urgent need to develop systematic measures at the national level, such as regular large-scale point-prevalence surveys, establishing a system for sharing clinical information on multidrug-resistant organism carriers, and providing financial support for active surveillance and isolation measures."

This content was produced with the assistance of AI translation services.