1080. Review of Carbapenem-Resistant Enterobacteriaceae (CRE) and Multi-Drug Resistant Organism (MDRO) Reporting Requirements in the United States
Session: Poster Abstract Session: Surveillance of HAIs: Implementation and National Perspectives
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
  • ID Week Poster Draft.pdf (1020.7 kB)
  • Background: CRE and MDROs have garnered attention recently due to increasing awareness on the threat posed to patient safety in the healthcare setting. Surveillance through mandated reporting is viewed as a strategy to minimize the spread of CRE/MDROs at the state and local level. From 2012-2013, the Maryland Department of Health and Mental Hygiene (DHMH) performed an extensive review to ascertain the current status of reporting requirements in US states for antimicrobial-resistant organisms, and identify potentially useful reportable conditions for implementation in Maryland.

    Methods: A systematic review of state health department websites, reporting regulations, and state-level notifiable disease lists was conducted to identify state-specific requirements for CRE and MDRO reporting. Phone interviews were conducted with select state HAI and MDRO coordinators to provide further information on reporting requirements, as well as lessons learned and best practices for CRE reporting implementation.

    Results: Seven states have current mandatory reporting requirements for CRE. Among states that have enacted CRE reporting, concerns over accurate case detection have been highlighted as a significant obstacle towards implementation. Mandatory CRE reporting was implemented and subsequently removed from one state's reportable disease list due to confusion among laboratories submitting samples. Vancomycin-resistant/intermediate Staphylococcus aureus (VRSA/VISA) is reportable in 42 states (including the District of Columbia), yet methicillin-resistant S. aureus (MRSA) is only mandated in 24 states, often for invasive or community-associated cases. Eight states require MRSA and Clostridium difficile reporting via NHSN LabID Event, aligning with CMS reimbursement rules.

    Conclusion: These findings emphasize the range of CRE/MDRO policies that exist across the US. The multiple organisms and antibiotic resistance profiles, evolving definitions, and conflicting laboratory methods for detection of CRE have served as significant hurdles to implementation of reporting requirements. Despite these difficulties, awareness of the successes and obstacles faced by other states in their respective reporting structures are integral for any state seeking to update their mandates.

    Byran Dai1, Malorie Givan, MPH2, Lucy Wilson, MD2 and Katherine Richards, MPH2, (1)Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, (2)Maryland Department of Health and Mental Hygiene, Baltimore, MD


    B. Dai, None

    M. Givan, None

    L. Wilson, None

    K. Richards, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.