1605. Statewide Acute Care Survey on Practices Regarding Carbapenem-Resistant Enterobacteriaceae in Oregon
Session: Poster Abstract Session: Multidrug-Resistant Gram Negative Rods
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Background: Carbapenem-resistant Enterobacteriaceae (CRE) are rare in Oregon, and infection control practices and knowledge among infection preventionists (IPs) are unknown.  A statewide survey of IPs was conducted to evaluate CRE infection control knowledge and practices.

Methods: In November 2012 we sent a 27-question self-administered survey to 62 infection control programs in acute care settings in Oregon.  Questions focused on facility-specific definitions of multi-drug resistant organisms (MDROs), infection control practices and surveillance around MDROs.

Results: Forty-five (73%) IC programs responded; not all responded to every question and non-responses dropped from the denominator. Nine (28%) programs defined multi-drug resistant (MDR) Enterobacteriaceae as resistant to at least two and 8 (25%) as resistant to three classes of antimicrobials; 13 (41%) used alternate classifications. When defining antibiotic class, the majority of IPs (N= 23; 70%) do not consider cephalosporins and β-lactams to be in the same antimicrobial class; 7 (21%) were unsure and 3 (9%) considered them to be within the same class. Three (9%) respondents have encountered CRE in their facility.  Eighty five percent of respondents would use contact precautions with CRE patients.  No facility has conducted a CRE point prevalence study.  Fifteen (45%) facilities report reviewing microbiology records to detect unrecognized CRE cases. Three facilities identified CRE in their facility as a result of retrospective review.  Fifty-eight percent of IPs agreed that their facility is aware of patients’ MDRO status upon admission.  When asked to rank the top 3 MDRO priorities in their facility, IPs rarely selected CRE (15%), while 42% ranked ESBL as a top priority. Most facilities are aware of the CDC CRE toolkit (N=31; 94%). All respondents expressed interest in CRE education; most desired formats included printed material (100%), presentations (97%), and webinars (91%).

Conclusion: Definitions of MDR Enterobacteriaceae vary widely across facilities and IPs are uncertain whether MDRO status of patients is communicated at the time of transfer.  Active surveillance for CRE is uncommon and CRE is not considered a high priority in most facilities.  These findings suggest opportunities to improve CRE education in Oregon.

Tasha Poissant, MPH1, Christopher Pfeiffer, MD2, Margaret Cunningham, MPH1, Ann Thomas, MD, MPH1, Jon Furuno, PhD3, John M. Townes, MD4 and Zintars G. Beldavs, MS1, (1)Oregon Health Authority, Portland, OR, (2)Portland VA Medical Center, Portland, OR, (3)OSU/Ohsu College of Pharmacy, Oregon State University, Portland, OR, (4)Oregon Health and Science University, Portland, OR

Disclosures:

T. Poissant, None

C. Pfeiffer, None

M. Cunningham, None

A. Thomas, None

J. Furuno, None

J. M. Townes, None

Z. G. Beldavs, None

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