Carbapenem-Resistant Enterobacterales (CRE)

In 2020, a taxonomy change was adopted to use “Enterobacterales” as the name of a new scientific order. “Enterobacteriaceae” are now a family within the “Enterobacterales” order, along with Erwiniaceae, Pectobacteriaceae, Yersiniaceae, Hafniaceae, Morganellaceae, and Budvicaceae.

General Information

Enterobacterales is an order of different types of bacteria commonly found in the human gut. There are several species of bacteria within the Enterobacterales order, which include, but are not limited to, Escherichia, Klebsiella, Enterobacter, Salmonella, Shigella, Citrobacter and Yersinia. Many species of Enterobacterales are necessary for digestion and are usually harmless when contained in the gut.

Species of the Enterobacterales order may develop resistance to a group of antibiotics called carbapenems. Carbapenems are often used as the last line of treatment when other antibiotics are not effective in treating Enterobacterales infections, and carbapenem resistance can make these infections very difficult to treat.

Information for Providers

This is a Wisconsin disease surveillance category I disease:

  • Category I diseases are of urgent public health importance and shall be reported IMMEDIATELY by telephone to the patient's local health officer, or to the local health officer's designee, upon identification of a case or suspected case. In addition to the immediate report, within 24 hours, complete and fax, mail, or submit a case report electronically through the Wisconsin Electronic Disease Surveillance System (WEDSS), or by other means. Public health intervention is expected as indicated. See Wis. Admin. Code § DHS 145.04 (3) (a) and Wis. Admin. Code § DHS 252.05.
  • CRE as a Reportable Condition in Wisconsin, Memo July 2018 (PDF)
    This memo serves as clarification that at this time carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) is the only type of CRE considered a category I condition requiring immediate notification. In addition, infection preventionists should continue to report CRE into the National Healthcare Safety Network (NHSN) in accordance to the NHSN CRE surveillance definition. Additional detail about reporting and follow-up for CRE is included within.
  • Information on communicable disease reporting

Wisconsin case reporting and public health follow-up guidelines

Wisconsin CRE prevention resources

Questions about CRE? Contact us!
Phone: 608-267-9003 | Fax: 608-261-4976

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Last Revised: October 7, 2021