The XDRO registry is a product of collaboration between IDPH, Medical Research Analytics and Informatics Alliance (MRAIA), and the Chicago CDC Prevention Epicenter.


IL CRE Detect and Protect Campaign

Background

The Illinois Department of Public Health (IDPH) is leading the statewide “CRE Detect and Protect” education campaign to promote practices that prevent carbapenem-resistant Enterobacterales (CRE) infections. CRE are extensively drug-resistant organisms (XDROs) with few antibiotic treatment options that can transfer their resistance to other bacteria. These deadly superbugs have been increasingly detected among patients in Illinois.

As part of the campaign, IDPH is working with hospitals, long-term care facilities, and laboratories to adopt the Centers for Disease Control and Prevention strategy of detecting CRE and protecting patients through appropriate infection control and prevention measures. IDPH is providing educational materials and online trainings on CRE prevention and use of the XDRO registry, which is a tool for sharing patient information across facilities and reporting CRE isolates to IDPH. A statewide CRE Task Force comprised of infectious disease and infection prevention experts is helping to guide efforts.

Campaign participants have the opportunity to learn from other healthcare facilities, laboratories, and CRE experts committed to this issue. Preventing the spread of these drug-resistant infections will result in better outcomes for patients and reduced healthcare costs in Illinois.

Funding

The CRE Detect and Protect Campaign is funded by an Affordable Care Act award from the Centers for Disease Control and Prevention.

Sponsors

Forms

IDPH Sponsor Memo and Form
IDPH Facility Participation Memo and Form

Resources

CRE resource packet for healthcare facilities
CRE packet for laboratories
Flowchart for reporting CRE to the XDRO registry

Workshops (click on titles for more information)

Description

IDPH’s Division of Patient Safety and Quality provided three infection prevention and CRE workshops in 2015. Training workshops were designed to coordinate regional approaches to CRE surveillance and response among infection prevention staff from acute and long-term care facilities, health department staff, and laboratorians. IDPH partnered with the following organizations to plan and provide these workshops: Illinois CRE Task Force, DuPage County Health Department, Cook County Department of Public Health, Chicago Department of Public Health, Illinois Academy of Family Physicians, Downstate Illinois Partnership Against Antibiotic Resistance, Southern Illinois University School of Medicine, American Society for Clinical Laboratory Science – Illinois Chapter.

Disclaimer: The opinions, viewpoints, and content presented by speakers in the workshops may not necessarily represent the position of the Illinois Department of Public Health.

Northern Illinois Workshop (Addison, IL)—May 12, 2015

Presentations (Click to download PDF)

CRE in Illinois: A Situational Update– Michael Lin, MD, MPH
Antimicrobial Stewardship at the Front Lines – David Schwartz, MD
CRE Surveillance and Prevention in Acute Care Hospitals – Maureen K. Bolon, MD, MS
Infection Prevention in Nursing Homes – Dheeraj Mahajan, MD, CMD, CIC
What Every Laboratory Should Be Doing to Detect CRE’s – Paul C. Schreckenberger, PhD, D(ABMM), F(AAM)
Antibiotic Resistance: Darwin, Semmelweis, & the Never Ending Story – Robert A. Weinstein, MD
Outbreak Management: It Takes a Village – Linda Stein, RN, MPH, CIC, CPHQ; Marguerite Gribogiannis, MPA, SM (ASCP) MT, CIC

Central Illinois Workshop (Springfield, IL)—July 28, 2015

Presentations (Click to download PDF)

CRE Detect and Protect Crash Course – Robynn Cheng Leidig, MPH
Recognizing Carbapenem-Resistant Enterobacterales: Crash Course for Non-Microbiologists – Nicholas Moore, MS, MLS(ASCP)CM
Carbapenem-Resistant Enterobacterales & Illinois’ XDRO Registry – William Trick, MD
Bad Bugs, No Drugs? An Ongoing Battle against MDR and XDR Pathogens – Janak Koirala, MD, MPH, FACP, FIDSA
Detect and Protect – Establishing an Infection Prevention and Control Plan for Carbapenem-Resistant Enterobacterales – Mary Alice Lavin, RN, MJ, CIC
Antimicrobial Stewardship: The OSF Experience – John Gavin Cotter, MD, MPH
Antimicrobial Stewardship Basics for Long Term Care – Tammy Woolsey, RN
CRE and CPO: Methods for Detection and Pitfalls to Avoid – Angella Charnot-Katsikas, MD

Southern Illinois Workshop (Carterville, IL)—July 23, 2015

Presentations (Click to download PDF)

CRE Detect and Protect Crash Course – Robynn Cheng Leidig, MPH
Recognizing Carbapenem-Resistant Enterobacterales: Crash Course for Non-Microbiologists – Nicholas Moore, MS, MLS(ASCP)CM
CRE in Illinois: A Situational Update – Allison Arwady, MD, MPH
Antibiotic Stewardship and Carbapenem-Resistant Enterobacterales (CRE) in the Acute Care Setting – Holly Brower, BSN, RN
CRE Infection and Prevention (Long-Term Care) – Virginia (Jenny) Pierce, RN, LNHA, RAC-CT
Laboratory Detection of CRE – Thomas Kirn, MD, PhD
Winning a Battle and Losing the War - Venkat R. Minnaganti, MD

CRE Case Studies

(Click to download PDF)

Presentation Slides
Case Study Handouts
CRE Regional Prevention Plan

Webinars (click on titles for more information)

Title: Laboratory Detection and Reporting of CRE
Date: June 6, 2014 from 10AM – 11:30AM CDT
Intended Audience: Hospital-affiliated, independent, or free-standing clinical laboratory staff

Description: Free educational webinar on laboratory detection methods of carbapenem-resistant Enterobacterales (CRE) and mandatory reporting to the Extensively Drug-Resistant Organism (XDRO) registry. Hosted by the Illinois Department of Public Health, Division of Patient Safety and Quality. After this session, participants will be able to: (1) Describe mechanisms of carbapenem resistance, (2) List criteria to be used for screening laboratory isolates for CRE, (3) Describe the procedure, interpretation, and application of the Hodge Test and MBL Etest, (4) List the pitfalls of susceptibility testing for the detection of CRE, (5) Prepare appropriate comments for reporting CRE, (6) Outline XDRO registry reporting guidelines, and (7) Explain how to navigate and use the XDRO registry.

Presenters: Paul Schreckenberger, Ph.D., D(ABMM), F(AAM) (Director, Clinical Microbiology Lab, Loyola University Medical Center)
William Trick, M.D. (Director, Collaborative Research Unit, Cook County Health & Hospitals System)
Michael Lin, M.D., M.P.H (Assistant Professor, Infectious Diseases, Rush University)

Link to recorded webinar: http://idph.adobeconnect.com/p354f2erxq8/
Link to slides: view


Title: CRE & XDRO for Long Term Care Facilities
Date: May 28, 2014 from 9:30AM – 11:00AM Central Time
Intended Audience: Long Term Care Facility infection prevention designees, Directors of Nursing, Assistant Directors of Nursing, other LTCF infection control and prevention staff

Description: Informational webinar on Carbapenem-Resistant Enterobacterales (CRE) and the Extensively Drug-Resistant Organisms (XDRO) registry. Hosted by the Illinois Department of Public Health, Division of Patient Safety and Quality. Webinar objectives include: (1) Define CRE; (2) Identify a CRE from a laboratory report; (3) Outline XDRO registry reporting guidelines; (4) Explain how to navigate and use the XDRO registry; and (5) Describe appropriate infection control practices and outbreak response.

Presenters: Deb Burdsall, MSN, RN-BC, CIC (Infection Preventionist, Lutheran Home/Lutheran Life Communities)
William Trick, M.D. (Director, Collaborative Research Unit, Cook County Health & Hospitals System)
Michael Lin, M.D. (Assistant Professor, Infectious Diseases, Rush University)

Link to recorded webinar: http://idph.adobeconnect.com/p9t3kek08u4/
Link to slides: view


Title: Long Term Care Infection Prevention Starts at the Top
Date: May 15, 2014 at 11am CDT
Intended Audience: Long Term Care Leaders, Quality Directors, and Administrators

Description:Informational webinar on patient safety and quality improvement initiatives in long term care facilities, with a focus on reducing healthcare-associated infections. Hosted by the Illinois Department of Public Health, Division of Patient Safety and Quality. Webinar topics include: (1) Discuss the spread of multi-drug resistant organisms and the effect on aging populations; (2) Discuss priorities related to patient safety, infection prevention, and quality improvement; (3) Present ideas on how to structure a system to reduce the spread of infections and save costs; (4) Identify appropriate infection prevention and laboratories resources; (5) Describe requirements for reporting to the Illinois Department of Public Health.

Presenters: Vishnu Chundi, M.D., Infectious Disease Specialist at Metro Infectious Disease Consultants

Link to recorded webinar: http://idph.adobeconnect.com/p8jq5rvxtba/
Link to slides: view


Title: Patient Safety and Quality Starts at the Top
Date: May 13, 2014
Intended Audience: Hospital Leaders, Quality Directors, and Administrators

Description:Informational webinar on hospital patient safety and quality improvement initiatives, and the role of infection prevention and antibiotic stewardship. Hosted by the Illinois Department of Public Health, Division of Patient Safety and Quality. Webinar objectives include: (1) Evaluate one health care systems approach to establishing system priorities related to patient safety, infection prevention, and quality; (2) Describe the use of metrics in public reporting, tracking & trending, analysis, improvements, and patient outcomes; (3) Explain the prioritization of infection prevention in patient outcomes through structure, focus and measurement; and (4) Examine a system program for mandatory vaccinations for associates and physicians.

Presenters: Rishi Sikka, M.D., Senior Vice President of Clinical Transformation, Advocate Health Care

Link to recorded webinar: http://idph.adobeconnect.com/p5y59t0e7ce/
Link to slides: view


Title: CRE & XDRO: What Hospital IC/Ps need to know
Date: April 29, 2014
Intended Audience: Hospital infection control and prevention staff

Description: Informational webinar on Carbapenem-Resistant Enterobacterales (CRE) and the Extensively Drug-Resistant Organisms (XDRO) registry. Hosted by the Illinois Department of Public Health, Division of Patient Safety and Quality. Webinar objectives include: (1) Define CRE, (2) Identify a CRE from a laboratory report, (3) Outline XDRO registry reporting guidelines, (4) Explain how to navigate and use the XDRO registry, (5) Describe appropriate infection control practices.

Presenters: Rose Marie Semar, RN BSN CIC CPPS (Presence Health, Resurrection Medical Center)
William Trick, M.D. (Cook County Health & Hospitals System)
Michael Lin, M.D. (Rush University)

Link to recorded webinar: http://idph.adobeconnect.com/p7uwvs7eo0o/
Link to slides: view


Title: CRE Detect and Protect: the Role of Local Health Departments
Date: March 26, 2014
Intended Audience: Local health department staff

Description: Informational webinar on: (1) Recognizing a CRE case, (2) Understanding how CRE is reported (XDRO registry), (3) Surveillance guidance, and (4) Outbreak response.

Presenters: Michael Vernon, DrPH (Cook County Department of Public Health)
Stacey Hoferka, MPH, MSIS (Illinois Department of Public Health)
Allison Arwady, MD, MPH (CDC Epidemic Intelligence Service and Illinois Department of Public Health)

Link to recorded webinar: http://idph.adobeconnect.com/p9s18rcgk8g/ (*Note that all files, including slides, are downloadable directly from the webinar recording).
Link to slides: view

Contact the CRE Project Directors

Angela Tang, MPH
angela.tang@illinois.gov