# Israel's nationwide containment of carbapenem-resistant Enterobacterales

**Solutions:**

- [Implement coordinated infection-control and outbreak-containment bundles](https://communityfix.org/issue/377)

**Outcome:** success
**Location:** Israel (31.5000, 34.8000) · scale: national
**Implementer:** Israel Ministry of Health and participating healthcare facilities

A clonal outbreak of carbapenem-resistant Klebsiella pneumoniae spread across Israeli hospitals during 2006 and was not controlled by local measures. In 2007 the Ministry of Health mandated physical separation of carriers, dedicated staffing, reporting to a central registry and daily central oversight of institutional containment. Later work extended control to post-acute-care facilities, showing that containment must follow patients across the full care network.

## Metrics

- **Monthly incidence of new CRE cases**: 55.5 at intervention start → 11.7 by May 2008 cases per 100,000 patient-days

## Lessons learned

- Regional spread cannot be controlled by isolated hospitals when patients move between facilities.
- Mandatory reporting, dedicated cohorts and central oversight can turn local practices into a functioning national system.

## Sources

- [Containment of a country-wide outbreak of carbapenem-resistant Klebsiella pneumoniae](https://pubmed.ncbi.nlm.nih.gov/21317398/)
- [Impact of the outbreak on Israel's national infection-control infrastructure](https://academic.oup.com/cid/article/65/12/2144/3979430)

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Canonical: https://communityfix.org/case-study/279