ICU CRE surge: rapid diagnostics, pharmacist-led audit, real-time lab comms

[TylerH]

I'm an infectious disease specialist at a regional hospital, and we're seeing a troubling increase in carbapenem-resistant Enterobacteriaceae (CRE) infections in our ICU over the last quarter. Our standard empiric antibiotic protocols are failing, leading to worse patient outcomes and longer stays. I'm leading a committee to revise our hospital's antimicrobial stewardship program to specifically address this surge. What are the most effective, actionable interventions beyond just restricting certain antibiotics? I'm particularly interested in rapid diagnostic testing implementation, pharmacist-led prospective audit and feedback models, and strategies for improving communication between the microbiology lab and the clinical teams in real-time.