The growing threat of carbapenem resistant enterobacteriaceae (CRE) within in-patient spinal rehabilitation units.

This case report highlights the present threat and challenges with treatment and transmission of infections caused by carbepenem-resistant enterobacteriaceae (CRE) within in-patient spinal rehabilitation units. The setting is within the Spinal Cord Injury Unit, Royal North Shore Hospital, Sydney, Australia. We report the case of a 45-year-old female with T9 complete paraplegia who developed CRE urinary tract infection (UTI) and sepsis 1 month post injury while in an in-patient spinal rehabilitation unit. We describe the challenges in treatment with colistin, the implications of infection on her rehabilitation and challenges in containing the spread of CRE to other patients in the unit. We present our experience with the management of CRE bactaeraemia in a spinal rehabilitation unit and the enhanced importance of infection control and surveillance strategies required to successfully contain risk of transmission.