Carbapenem-resistant organisms (CROs) are among the most urgent threats facing hospitals today. This group includes carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant Acinetobacter baumannii (CRAB), and carbapenem-resistant Pseudomonas aeruginosa (CRPA). Each presents unique challenges, but all share the ability to resist nearly every antibiotic, leaving clinicians with few treatment options.
The CDC classifies CRE as an urgent public health threat due to high mortality, limited therapies, and growing community spread. CRAB has been particularly problematic in long-term acute care and rehabilitation hospitals, where patients are vulnerable and length of stay is extended. CRPA, meanwhile, is associated with severe pneumonia and bloodstream infections, with significantly higher mortality when carbapenemase genes are present.
Recent epidemiologic reports highlight alarming trends: the prevalence of NDM-positive CRE rose in New York City from 58 isolates in 2019 to 388 in 2024, surpassing the long-dominant KPC-producing strains (CDC MMWR). Outbreaks of CROs have also been reported across the Southwest U.S., reinforcing concerns about rapid regional spread.
The Arizona Republic recently reported: “CRE, a nightmare bacteria infection, is on the rise in Arizona”. The article describes outbreaks across the region, including long-term and rehab facilities, underscoring the urgency of proactive infection prevention.
👉 Read the full article here.
While antimicrobial stewardship and standard infection control remain essential, hospitals are increasingly turning to automated aerosolized hydrogen peroxide (aHP) disinfection as a frontline defense.
aHP enables whole-room decontamination that reaches all surfaces and hidden spaces, reducing reliance on manual cleaning. Unlike traditional spray-and-wipe methods, aHP systems are:
Rapid – covering entire rooms or transport vehicles in minutes.
Low-labor – requiring minimal staff intervention.
Consistent – delivering reproducible coverage and efficacy.
Validated – achieving high-level reduction of pathogens including CROs, with published studies showing effectiveness against multidrug-resistant organisms.
By closing the gap left by manual cleaning, aHP has become an essential infection prevention tool in environments where CROs pose the greatest risks.
At a rehabilitation hospital in the Southwest U.S., clinicians implemented a comprehensive CRO mitigation strategy that included our Breezy Blue™ aHP-based automated disinfection system with real-time auditing.
Over a 24-month period (January 2023–July 2025), the hospital admitted 24 patients colonized or infected with CROs. During this time, no confirmed in-facility CRO transmissions occurred. These results—previewed in an abstract presented at an APIC regional chapter meeting—underscore how combining robust infection prevention practices with aHP disinfection can dramatically reduce CRO spread in high-risk care settings.
Carbapenem-resistant organisms are spreading rapidly across the U.S., especially in the Southwest. These “nightmare bacteria” carry high mortality, disrupt hospital operations, and pose significant risks to patients. Yet, as real-world hospital data now show, integrating automated aHP disinfection into infection prevention strategies can prevent their spread.
Hospitals adopting the newest generation of aHP tools demonstrate that even the most formidable pathogens can be controlled.