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Establishment of a Statewide Network for Carbapenem-Resistant Enterobacteriaceae Prevention in a Low-Incidence Region

Published online by Cambridge University Press:  10 May 2016

Christopher D. Pfeiffer ,
Margaret C. Cunningham ,
Tasha Poissant ,
Jon P. Furuno ,
John M. Townes ,
Andrew Leitz ,
Ann Thomas ,
Genevieve L. Buser ,
Robert F. Arao  and
Zintars G. Beldavs
Christopher D. Pfeiffer*
Affiliation:
Department of Hospital and Specialty Medicine, Portland Veterans Affairs Medical Center, Portland, Oregon Department of Medicine, Oregon Health and Science University, Portland, Oregon
Margaret C. Cunningham
Affiliation:
Oregon Public Health Division, Oregon Health Authority, Portland, Oregon
Tasha Poissant
Affiliation:
Oregon Public Health Division, Oregon Health Authority, Portland, Oregon
Jon P. Furuno
Affiliation:
Oregon State University/Oregon, Health and Science University College of Pharmacy, Portland, Oregon
John M. Townes
Affiliation:
Department of Hospital and Specialty Medicine, Portland Veterans Affairs Medical Center, Portland, Oregon
Andrew Leitz
Affiliation:
Department of Medicine, Oregon Health and Science University, Portland, Oregon
Ann Thomas
Affiliation:
Oregon Public Health Division, Oregon Health Authority, Portland, Oregon
Genevieve L. Buser
Affiliation:
Oregon Public Health Division, Oregon Health Authority, Portland, Oregon
Robert F. Arao
Affiliation:
Oregon Public Health Division, Oregon Health Authority, Portland, Oregon
Zintars G. Beldavs
Affiliation:
Oregon Public Health Division, Oregon Health Authority, Portland, Oregon
*
Portland Veterans Affairs Medical Center, PO Box 1034 P3-ID, Portland, OR 97239 (pfeiffec@ohsu.edu)
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Abstract

Objective.

To establish a statewide network to detect, control, and prevent the spread of carbapenem-resistant Enterobacteriaceae (CRE) in a region with a low incidence of CRE infection.

Design.

Implementation of the Drug Resistant Organism Prevention and Coordinated Regional Epidemiology (DROP-CRE) Network.

Setting and Participants.

Oregon infection prevention and microbiology laboratory personnel, including 48 microbiology laboratories, 62 acute care facilities, and 140 long-term care facilities.

Methods.

The DROP-CRE working group, comprising representatives from academic institutions and public health, convened an interdisciplinary advisory committee to assist with planning and implementation of CRE epidemiology and control efforts. The working group established a statewide CRE definition and surveillance plan; increased the state laboratory capacity to perform the modified Hodge test and polymerase chain reaction for carbapenemases in real time; and administered surveys that assessed the needs and capabilities of Oregon infection prevention and laboratory personnel. Results of these inquiries informed CRE education and the response plan.

Results.

Of 60 CRE reported from November 2010 through April 2013, only 3 were identified as carbapenemase producers; the cases were not linked, and no secondary transmission was found. Microbiology laboratories, acute care facilities, and long-term care facilities reported lacking carbapenemase testing capability, reliable interfacility communication, and CRE awareness, respectively. Survey findings informed the creation of the Oregon CRE Toolkit, a state-specific CRE guide booklet.

Conclusions.

A regional epidemiology surveillance and response network has been implemented in Oregon in advance of widespread CRE transmission. Prospective surveillance will determine whether this collaborative approach will be successful at forestalling the emergence of this important healthcare-associated pathogen.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 35 , Issue 4: Special Topic Issue: Carbapenem-Resistant Enterobacteriaceae and Multidrug-Resistant Organisms , April 2014 , pp. 356 - 361
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2014

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