351. Carbapenem-resistant Enterobacteriaceae reported to the National Healthcare Safety Network multidrug-resistant organism module, January 2013–December 2015
Session: Poster Abstract Session: HAI: Multi Drug Resistant Gram Negatives
Thursday, October 27, 2016
Room: Poster Hall
Background: Surveillance for carbapenem-resistant Enterobacteriaceae (CRE) is critical for limiting their spread. The National Healthcare Safety Network (NHSN) multidrug-resistant organism (MDRO) module laboratory-identified event (LabID) option is available for CRE clinical culture surveillance. We describe CRE reported via this module and characterize the burden of facility reporting.

Methods: We analyzed CRE reported by short-stay acute care general hospitals performing facility-wide inpatient LabID surveillance during January 1, 2013-December 31, 2015. During 2013-14, CRE were defined as Klebsiella oxytoca, Klebsiella pneumoniae or Escherichia coli, non-susceptible to imipenem, meropenem, or doripenem. In 2015, CRE were defined as any of these organisms or Enterobacter spp. resistant to any carbapenem, including ertapenem, or with a carbapenemase present. We evaluated characteristics of patients and reporting facilities and calculated the mean monthly facility CRE rate.

Results: Over the 3 years, events were reported from 342 facilities (170 [50%] teaching, 88% ≤500 beds) in 22 states. There were 10927 events in 8252 patients (4168 [51%] female, median age 69 years [range <1-110]). Among events, 9220 (84%) were Klebsiella spp., 990 (9%) E.coli, and 717 (7%) Enterobacter spp; 5510 (50%) events were hospital-onset. In 2015, when all 3 genera were reported, there were 3641 (76%) Klebsiella spp., 411 (9%) E. coli, and 717 (15%) Enterobacter spp. During 2013-14, the mean CRE rate was 0.66 events/facility-month (range 0-14.44); for 2015, the rate was 0.73 events/facility-month (range 0-13.08). Among facilities reporting ≥6 months of data in 2015 (269), 175 (65%) reported ≤1 CRE per month. Among states with mandatory CRE reporting during 2013-15 and ≥1 year of data in the MDRO module (n=3), the overall mean facility CRE event rate was 0.55 events/month; rates by state were 0.08, 0.08, and 1.5.

Conclusion: The majority of facilities performing surveillance via the MDRO module reported ≤1 CRE a month, highlighting the limited burden of CRE reporting. However, facility rates varied nearly twenty-fold among states with mandatory reporting. This heterogeneity demonstrates the importance of surveillance in targeting prevention strategies.

Amber Vasquez, MD, MPH, Centers for Disease Control and Prevention, Atlanta, GA, Maroya Walters, PhD, Division of Healthcare Quality Promotion, Center for Disease Control and Prevention, Atlanta, GA and Alexander Kallen, MD, MPH, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA


A. Vasquez, None

M. Walters, None

A. Kallen, None

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