Antimicrobial Resistance Information for Healthcare Providers

Epidemiology and Informatics
Public Health

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    ​Reportable Organisms

    Nebraska updated its regulations on reportable diseases January 1, 2017. Now they include the organisms listed below. Disease reports allows DHHS to track patterns of susceptibility. That way, DHHS can detect any resistance patterns of concern. DHHS will also be able to identify and control outbreaks.

    Required to be reported immediately

    • Carbapenem resistant Enterobacteriaceae
    • Staphylococcus aureus, vancomycin-intermediate/resistant

    Applies only to laboratories that do their reports electronically:

    • Acinetobacter species
    • Citrobacter species
    • Enterobacter species
    • Enterococcus species
    • Escherichia coli
    • Klebsiella species
    • Pseudomonas aeruginosa

    Emerging Resistant Organisms

    The HAI Program receives reports of emerging resistant organisms. These organisms include

    • All carbapenem-resistant Enterobacteriaceae (CREs)
    • CREs that produce carbapenemases
    • Carbapenem resistant Pseudomonas species
    • Colistin resistant Acinetobacter (mcr-1 gene) and CRAB CRPA (Carbapenem Resistant Acinetobacter baumanii).
    • Candida auris
    • Staphylococcus aureus, vancomycin-intermediate/resistant
    • M. chimaera

    Carbapenem Resistant Organisms

    Bacteria can become resistant to certain classes of antibiotics. One of those classes is carbapenem class. Examples of antibiotics in that class:

    • Doripenem,
    • Ertapenem,
    • Imipenem,
    • Meropenem.

    These bacteria are a group of emerging pathogens; they are a reason for worry. CDC notes that Carbapenem Resistant Enterobacteriaceae (CRE) are a major cause of invasive infections. Often there is a link between CRE bacteria and high mortality rates, up to 50%.

    You can find CRE bacteria in most of the U.S. CRE bacteria are mainly associated with exposure to the healthcare system. In addition, CRE can spread in the community.

    Nebraska Title 173 Chapter 1 requires labs and healthcare providers to report immediately carbapenem resistant Enterobacteriaceae (suspected or confirmed). They must report it within 24 hours by email, fax or phone and by ELR if available.

    CRE Data

    The DHHS HAI Program, along with the Nebraska Public Health Laboratory (NPHL), tracks and researches CREs in Nebraska.

    CRE Guidelines and Forms

    Additional Resources