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Healthcare-Associated Infections (HAI)
 
Antimicrobial Resistance Information for Healthcare Providers
 
Reportable Organisms
 
Nebraska reportable disease regulations were updated January 1, 2017 to include the organisms listed below. Reporting enables DHHS to monitor susceptibility patterns in order to detect concerning resistance patterns and identify and control outbreaks.
 
Required to be reported immediately:
  • Carbapenem-resistant Enterobacteriaceae
  • Staphylococcus aureus, vancomycin-intermediate/resistant
Applies only to laboratories reporting electronically:
  • Acinetobacter species
  • Citrobacter species
  • Enterobacter species
  • Enterococcus species
  • Escherichia coli
  • Klebsiella species
  • Pseudomonas aeruginosa 

Emerging Resistant Organisms

The HAI Program monitors for reports of emerging resistant organisms, including:

  • All carbapenem resistant Enterobacteriaceae (CREs)
    • CREs that produce carbapenemases
    • Carbapenem resistant Pseudomonas species
  • Colistin resistant Acinetobacter (mcr-1 gene)
  • Candida auris
  • Staphylococcus aureus, vancomycin-intermediate/resistant

Carbapenem Resistant Organisms

Bacteria that develop resistance to the carbapenem class (doripenem, ertapenem, imipenem, meropenem) of antibiotics represent a concerning group of emerging pathogens. CDC notes that Carbapenem Resistant Enterobacteriaceae (CRE) are an important cause of invasive infections and are often associated with high mortality rates, up to 50%. CRE bacteria have been found in most of the U.S. and are primarily associated with exposure to the healthcare system. CRE has the potential to spread in the community.

In accordance with Nebraska Title 173 Chapter 1, carbapenem resistant Enterobacteriaceae (suspected or confirmed) must be reported immediately (within 24 hours by email, fax or phone and by ELR if available).

CRE Data

The DHHS HAI program in conjunction with the Nebraska Public Health Laboratory (NPHL) monitors for and investigates CREs in Nebraska.

Number of Carbapenem Resistant Organisms Investigated and Confirmed (Data Chart).

CRE Guidelines and Forms

CRE Outbreak Response Guidelines

CRE Case Investigation Form

CRE Investigation Guidelines

Facility Guidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE)

For questions about CRE reporting and investigaiton, Contact the HAI Program.

Additional Resources from CDC:

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