Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-28T08:29:43.641Z Has data issue: false hasContentIssue false
  • English
  • Français

Laboratory practices for identification and reporting of carbapenem-resistant Enterobacteriaceae in Department of Veterans Affairs facilities

Published online by Cambridge University Press:  04 March 2019

Margaret A. Fitzpatrick Open the ORCID record for Margaret A. Fitzpatrick [Opens in a new window] ,
Katie J. Suda ,
Swetha Ramanathan ,
Marylou Guihan ,
Charnetta Brown ,
Nasia Safdar ,
Martin Evans ,
Makoto M. Jones ,
Christopher D. Pfeiffer  and
J. Stacey Klutts
...Show all authors
Margaret A. Fitzpatrick*
Affiliation:
Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr, VA Hospital, Hines, Illinois Division of Infectious Diseases, Department of Medicine, Loyola University Stritch School of Medicine, Maywood, Illinois
Katie J. Suda
Affiliation:
Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr, VA Hospital, Hines, Illinois Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, Illinois
Swetha Ramanathan
Affiliation:
Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr, VA Hospital, Hines, Illinois
Marylou Guihan
Affiliation:
Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr, VA Hospital, Hines, Illinois Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois
Charnetta Brown
Affiliation:
Department of Veterans Affairs, Houston Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas
Nasia Safdar
Affiliation:
Department of Veterans Affairs, William S. Middleton Memorial VA Medical Center, Madison, Wisconsin Department of Medicine, Division of Infectious Diseases, University of Wisconsin School of Public Health and Medicine, Madison, Wisconsin
Martin Evans
Affiliation:
Department of Veterans Affairs, Lexington VA Medical Center, Lexington, Kentucky
Makoto M. Jones
Affiliation:
Department of Veterans Affairs, VA Salt Lake City Healthcare System, Salt Lake City, Utah Division of Epidemiology, Department of Medicine, University of Utah, Salt Lake City, Utah
Christopher D. Pfeiffer
Affiliation:
Department of Veterans Affairs, Portland VA Healthcare System, Portland, Oregon Division of Infectious Diseases, Department of Medicine, Oregon Health Science University, Portland, Oregon
J. Stacey Klutts
Affiliation:
Department of Veterans Affairs, Iowa City VA Health Care System, Iowa City, Iowa Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, Iowa
Michael Icardi
Affiliation:
Department of Veterans Affairs, Iowa City VA Health Care System, Iowa City, Iowa Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, Iowa
Eli Perencevich
Affiliation:
Department of Veterans Affairs, Iowa City VA Health Care System, Iowa City, Iowa Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
Michael Rubin
Affiliation:
Department of Veterans Affairs, VA Salt Lake City Healthcare System, Salt Lake City, Utah Division of Epidemiology, Department of Medicine, University of Utah, Salt Lake City, Utah
Charlesnika T. Evans
Affiliation:
Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr, VA Hospital, Hines, Illinois Center for Healthcare Studies and Department of Preventive Medicine Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
the QUERI CARRIAGE Program
Affiliation:
Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr, VA Hospital, Hines, Illinois Division of Infectious Diseases, Department of Medicine, Loyola University Stritch School of Medicine, Maywood, Illinois Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, Illinois Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois Department of Veterans Affairs, Houston Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, Texas Department of Veterans Affairs, William S. Middleton Memorial VA Medical Center, Madison, Wisconsin Department of Medicine, Division of Infectious Diseases, University of Wisconsin School of Public Health and Medicine, Madison, Wisconsin Department of Veterans Affairs, Lexington VA Medical Center, Lexington, Kentucky Department of Veterans Affairs, VA Salt Lake City Healthcare System, Salt Lake City, Utah Division of Epidemiology, Department of Medicine, University of Utah, Salt Lake City, Utah Department of Veterans Affairs, Portland VA Healthcare System, Portland, Oregon Division of Infectious Diseases, Department of Medicine, Oregon Health Science University, Portland, Oregon Department of Veterans Affairs, Iowa City VA Health Care System, Iowa City, Iowa Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, Iowa Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa Center for Healthcare Studies and Department of Preventive Medicine Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
*
Author for correspondence: Margaret A. Fitzpatrick, Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Laboratory identification of carbapenem-resistant Enterobacteriaceae (CRE) is a key step in controlling its spread. Our survey showed that most Veterans Affairs laboratories follow VA guidelines for initial CRE identification, whereas 55.0% use PCR to confirm carbapenemase production. Most respondents were knowledgeable about CRE guidelines. Barriers included staffing, training, and financial resources.

Type
Concise Communication
Information
Infection Control & Hospital Epidemiology , Volume 40 , Issue 4 , April 2019 , pp. 463 - 466
Creative Commons
This work is classified, for copyright purposes, as a work of the U.S. Government and is not subject to copyright protection within the United States.
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Xu, L, Sun, X, Ma, X. Systematic review and meta-analysis of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniae. Ann Clin Microbiol Antimicrob 2017;16:18.CrossRefGoogle ScholarPubMed
2017 Guideline for Control of Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae (CP-CRE). Washington, DC: National Infectious Disease Service MDRO Prevention Office, Veterans Health Administration, Department of Veterans Affairs; 2017.Google Scholar
Facility Guidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE): November 2015 Update--CRE Toolkit. Centers for Disease Control and Prevention website. https://www.cdc.gov/hai/pdfs/cre/CRE-guidance-508.pdf. Published 2015. Accessed Nov 1, 2017.Google Scholar
Fitzpatrick, MA, Suda, KJ, Jones, MM, et al. Effect of varying federal definitions on prevalence and characteristics associated with carbapenem-resistant Enterobacteriaceae in veterans with spinal cord injury. Am J Infect Control 2018;47:175–179. pii: S0196-6553(18)30825-3. doi: 10.1016/j.ajic.2018.08.001.CrossRefGoogle ScholarPubMed
Lin, MY, Lyles-Banks, RD, Lolans, K, et al. The importance of long-term acute care hospitals in the regional epidemiology of Klebsiella pneumoniae carbapenemase-producing Enterobacteriaceae. Clin Infect Dis 2013;57:1246–1252.CrossRefGoogle ScholarPubMed
Harris, PA, Taylor, R, Thielke, R, Payne, J, Gonzalez, N, Conde, JG. Research electronic data capture (REDCap) — a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009;42:377–381.CrossRefGoogle ScholarPubMed
Damschroder, LJ, Aron, DC, Keith, RE, Kirsh, SR, Alexander, JA, Lowery, JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci 2009;4:50.CrossRefGoogle ScholarPubMed
Humphries, RM, Hindler, JA, Epson, E, et al. Carbapenem-resistant Enterobacteriaceae detection practices in California: What are we missing? Clin Infect Dis 2018;66:1061–1067.CrossRefGoogle ScholarPubMed
Thibodeau, E, Duncan, R, Snydman, DR, et al. Carbapenem-resistant Enterobacteriaceae: a statewide survey of detection in Massachusetts hospitals. Infect Control Hosp Epidemiol 2012;33:954–956.CrossRefGoogle ScholarPubMed
Gohil, SK, Singh, R, Chang, J, et al. Emergence of carbapenem-resistant Enterobacteriaceae in Orange County, California, and support for early regional strategies to limit spread. Am J Infect Control 2017;45:1177–1182.CrossRefGoogle ScholarPubMed