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    Bulens, Sandra N. Yi, Sarah H. Walters, Maroya S. Jacob, Jesse T. Bower, Chris Reno, Jessica Wilson, Lucy Vaeth, Elisabeth Bamberg, Wendy Janelle, Sarah J. Lynfield, Ruth Vagnone, Paula Snippes Shaw, Kristin Kainer, Marion Muleta, Daniel Mounsey, Jacqueline Dumyati, Ghinwa Concannon, Cathleen Beldavs, Zintars Cassidy, P. Maureen Phipps, Erin C. Kenslow, Nicole Hancock, Emily B. and Kallen, Alexander J. 2018. Carbapenem-Nonsusceptible Acinetobacter baumannii, 8 US Metropolitan Areas, 2012–2015. Emerging Infectious Diseases, Vol. 24, Issue. 4, p. 727.
    Magill, Shelley S. Dumyati, Ghinwa Ray, Susan M. and Fridkin, Scott K. 2015. Evaluating Epidemiology and Improving Surveillance of Infections Associated with Health Care, United States. Emerging Infectious Diseases, Vol. 21, Issue. 9, p. 1537.
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Querying Automated Antibiotic Susceptibility Testing Instruments: A Novel Population-Based Active Surveillance Method for Multidrug-Resistant Gram-Negative Bacilli

  • Jessica Reno (a1) (a2) (a3), Calista Schenck (a1) (a2) (a3), Janine Scott (a1) (a2) (a3), Leigh Ann Clark (a1) (a2) (a3), Yun F. (Wayne) Wang (a2) (a4) (a5), Susan Ray (a1) (a2) (a3) (a4) (a5), Paula Snippes Vagnone (a6) and Jesse T. Jacob (a2) (a5)...
Abstract
Objective.

To describe the implementation of a population-based surveillance system for multidrug-resistant gram-negative bacilli (MDR-GNB).

 Design.

Population-based active surveillance by the Georgia Emerging Infections Program.

 Setting.

Metropolitan Atlanta, starting November 2010.

 Patients.

Residents with MDR-GNB isolated from urine or a normally sterile site culture.

 Methods.

Surveillance was implemented in 3 phases: (1) surveying laboratory antibiotic susceptibility testing practices, (2) piloting surveillance to estimate the proportion of GNB that were MDR, and (3) maintaining ongoing active surveillance for carbapenem-nonsusceptible Enterobacteriaceae and Acinetobacter baumannii using the 2010 Clinical and Laboratory Standards Institute (CLSI) breakpoints. Pilot surveillance required developing and installing queries for GNB on the 3 types of automated testing instruments (ATIs), such as MicroScan, in Atlanta's clinical laboratories. Ongoing surveillance included establishing a process to extract data from ATIs consistently, review charts, manage data, and provide feedback to laboratories.

 Results.

Output from laboratory information systems typically used for surveillance would not reliably capture the CLSI breakpoints, but queries developed for the 3 ATIs did. In November 2010, 0.9% of Enterobacteriaceae isolates and 35.7% of A. baumannii isolates from 21 laboratories were carbapenem nonsusceptible. Over a 5-month period, 82 Enterobacteriaceae and 59 A. baumannii were identified as carbapenem nonsusceptible.

 Conclusions.

Directly querying ATIs, a novel method of active surveillance for MDR-GNB, proved to be a reliable, sustainable, and accurate method that required moderate initial investment and modest maintenance. Ongoing surveillance is critical to assess the burden of and changes in MDR-GNB to inform prevention efforts.
Copyright
COPYRIGHT: © The Society for Healthcare Epidemiology of America 2014
Corresponding author
Orr Building 1020, 550 Peachtree Street NE, Atlanta, GA 30308 (jtiacob@emory.edu)
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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