2012 CRE Toolkit - Guidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE)

Part 2: Regional CRE Prevention

Appendix C: Example of a Survey for Infection Preventionists

 

Instructions for Administering Survey for Carbapenem-resistant Enterobacteriaceae (CRE)

Given the increasing incidence of CRE in parts of the United States and the potential for widespread dissemination, health departments are encouraged to assess the incidence of CRE within their jurisdictions to guide response efforts. To facilitate this activity, the attached survey has been designed to be used by health departments to determine: 1) the frequency of CRE colonized- or infected patients identified, 2) the type of surveillance conducted, and 3) the infection control measures implemented to prevent transmission.

It is recommended that health departments administer this survey by telephone to infection prevention personnel of all acute care hospitals and long-term acute care hospitals within their jurisdictions; this survey could also be modified for use in other long-term care facilities. The survey consists of 7 questions and will take approximately 5 minutes to complete.

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Survey of Healthcare Facilities for Carbapenem-resistant Enterobacteriaceae (CRE)

1. Does the microbiology laboratory that performs cultures for your facility have an established system for alerting infection prevention staff in a timely manner (i.e., within 24 hrs) whenever a carbapenem-resistant Enterobacteriaceae isolate is identified?
   Yes     No
2. In the past 12 months, have any CRE infected- or colonized-patients been present in your facility?
   Yes     No
   If YES,
   1. In general, how often do you identify CRE infected- or colonized-patients from clinical cultures?
      Daily     Weekly     Monthly     Biannually     Yearly    
   2. Specifically, how often are CRE infected- or -colonized patients identified from clinical cultures collected in the following categories:
      
      1. From cultures collected before or within 48 hours of admission (i.e., transfers or community-onset)?
         Daily     Weekly     Monthly     Biannually     Yearly     Not Identified
      2. From cultures collected after 48 hours of admission (i.e., hospital-onset)?
         Daily     Weekly     Monthly     Biannually     Yearly     Not Identified
3. If CRE cases have not been identified or have only rarely been identified (i.e., 0-3 cases per quarter), has your facility ever reviewed 6 to 12 months of microbiology records to detect any previously unrecognized CRE cases?
   Yes     No
   If YES, did your review identify any previously unrecognized CRE cases?
   Yes     No
   
4. Has your facility ever conducted a point prevalence survey (single round of active surveillance cultures) for CRE in high-risk units (e.g., units where previously unrecognized cases were identified, ICU, and units with high antimicrobial utility)?
   Yes     No
   If YES, did your facility identify any unrecognized CRE?
   Yes     No
5. If a CRE case is identified, does your facility conduct active surveillance testing of patients with epidemiologic links to the CRE case (e.g., patients in same unit or who were provided care by same healthcare personnel)?
   Yes     No
6. If a patient infected or colonized with CRE is identified, which of the following measures are implemented (check all that apply):
   1. Place on Contact Pecautions
      Yes     No
   2. Place in single-patient rooms when possible
      Yes     No
   3. Other:
      

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7. In your opinion, does your facility consider CRE to be an epidemiologically important multidrug-resistant organism for which specific infection control practices are indicated to eliminate transmission?
   Strongly Agree     Agree     Neither     Disagree     Strongly Disagree    

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