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

Reporting Rule

Starting November 1, 2013, the first CRE-positive culture per patient stay must be reported to the XDRO registry.


CRE definition

Enterobacterales (e.g., E. coli, Klebsiella species, Enterobacter species, Proteus species, Citrobacter species, Serratia species, Morganella species, or Providentia species) with one of the following laboratory test results:

  1. Molecular test (e.g., polymerase chain reaction [PCR]) specific for carbapenemase;
  2. Phenotypic test (e.g., Modified Hodge) specific for carbapenemase production;
  3. For E. coli and Klebsiella species only (excluding K. aerogenes): non-susceptible (intermediate or resistant) to ONE of the following carbapenems (doripenem, meropenem, or imipenem) AND resistant to ALL of the following third generation cephalosporins tested (ceftriaxone, cefotaxime, and ceftazidime). Note: ignore ertapenem for this definition.

Consult with your microbiology laboratory regarding which CRE tests are available. For some laboratories, only #3 will be available.


Carbapenem-Resistant Acinetobacter baumannii (CRAB) definition

Acinetobacter baumannii with one of the following laboratory test results:

  1. Molecular test (e.g., polymerase chain reaction [PCR]) specific for carbapenemase, or
  2. Resistant to at least one of the following carbapenems (doripenem, meropenem, or imipenem). Note: ignore ertapenem for this definition.

Candida auris (C. auris) definition

Confirmatory laboratory evidence of Candida auris using either culture or a validated culture-independent test (e.eg., NAAT [Nucleic Acid Amiplification Test]).


Carbapenemase Producing – Carbapenem Resistant Pseudomonas aeruginosa (CP-CRPA) definition

Pseudomonas aeruginosa with one of the following laboratory test results:

  1. Molecular test (e.g. polymerase chain reaction [PCR]) specific for carbapenemase, or
  2. Phenotypic test specific for carbapenemase production.

From the Joint Committee on Administrative Rules – Administrative Code

TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER k: COMMUNICABLE DISEASE CONTROL AND IMMUNIZATIONS
PART 690 CONTROL OF NOTIFIABLE DISEASES AND CONDITIONS CODE
SUBPART J: REGISTRIES

DELETE EVERYTHING BELOW THIS & ADD:

SECTION 690.1500 EXTENSIVELY DRUG-RESISTANT ORGANISM REGISTRY

a) This Section establishes an Extensively Drug-Resistant Organism (XDRO) Registry to collect data on persons entering health care facilities who have been diagnosed with an XDRO infection. Options for treating patients with XDRO infections are often limited, and XDRO infections are associated with increased lengths of stay, costs and mortality. The Registry is established to protect patients and to stop the spread of communicable disease in health care facilities.
b) XDROs to be included in the registry include non-duplicative XDROs considered to be of epidemiologic importance due to either severity of clinical disease, potential for transmission of genetic elements, or opportunities for effective control efforts.

(Source: Amended at 38 Ill. Reg. 5533, effective February 11, 2014)

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SECTION 690.1510 ENTITIES REQUIRED TO SUBMIT INFORMATION

The Department requires the following health care facilities to report patient XDRO incident information:

a) Hospitals;
b) Hospital-affiliated clinical laboratories;
c) Independent or free-standing laboratories;
d) Long-term care facilities; and
e) Long-term acute care hospitals (LTACHs)

(Source: Added at 37 Ill. Reg. 12063, effective July 15, 2013)

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SECTION 690.1520 INFORMATION REQUIRED TO BE REPORTED

a) A facility required to submit XDRO information shall report each Non Duplicative XDRO Isolate, as specified in this Section, to the Department.
b) The information to be reported shall be provided in a format designated by the Department and may be submitted either by direct electronic transmission or entry into a website. The information to be reported is divided into four subject areas, each containing a particular set of information. The four subject areas of the incidence report shall include the following:
1) Patient Data and Address - patient's full name (including maiden name, when applicable and available), last four digits of the Social Security number (if available), telephone number and residential address, including street address, city, county, state and postal code;
2) Personal Data - patient's birth date, sex, race and ethnicity (if available);
3) Culture Data - specimen collection date, specimen source, isolate genus, isolate species, specific carbapenemase name (if known), antiboticresistance criteria for entry into the Registry; and
4) Facility Data - facility identification number provided by the Department, the medical record number, and the date of admission.
c) Each XDRO report shall be submitted within seven calendar days after the test result is finalized.
d) Upon request from the Department or the Department's designee, each reporting facility shall provide access to additional information from all medical, pathological and other pertinent records related to the XDRO diagnosis, treatment, and follow-up for the purposes of infection control and quality improvement.
e) Reporting facilities shall report carbapenem-resistant Enterobacterales (e.g., E. coli, Klebsiella species, Enterobacter species, Proteus species, Citrobacter species, Serratia species, Morganella species, or Providentia species) based on laboratory test results:
1) Molecular test (e.g., polymerase chain reaction (PCR)) specific for carbapenemase;
2) Phenotypic test (e.g., Modified Hodge) specific for carbapenemase production; or
3) Enterobacterales that are non-susceptible or resistant to designated antibiotics, as defined by susceptibility testing results.

(Source: Amended at 39 Ill. Reg. 11063, effective July 24, 2015)

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SECTION 690.1530 METHODS OF REPORTING XDRO REGISTRY INFORMATION

a) All patients identified at a reporting facility with a non-duplicative XDRO are reportable to the Registry within seven calendar days after the test result is finalized.
b) A reporting facility may report XDRO infections by one of the following methods:
1) Option #1. Electronic Reporting: Health care facilities that have the capacity to submit laboratory data electronically may use this option.
2) Option #2. Manual Entry into a Website: Facilities that do not have the capacity to submit laboratory data electronically shall submit the data through a Department-approved website.

(Source: Added at 37 Ill. Reg. 12063, effective July 15, 2013)

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SECTION 690.1540 AVAILABILITY OF INFORMATION

a) The Department will use information in the XDRO Registry for the following purposes:
1) To provide appropriate information to a physician or institution providing care or treatment to a person;
2) To alert health care facilities of the admission of a patient with an XDRO infection; and
3) To assess the burden of XDROs in health care facilities located in Illinois.
b) The Department will maintain the confidentiality of information in the XDRO Registry that would identify individual patients. The Department will handle confidentiality of XDRO Registry information as set forth in Section 690.200(d).
c) The Department may release summary statistics from the XDRO Registry to highlight or prevent a population based public health problem or to highlight the State or regional burden of XDROs. Any summary statistics released by the Department will not reveal the identity of the reporting health care facility or a patient.
d) The availability of XDRO Registry information will be in accordance with the Health and Hazardous Substances Registry Code (77 Ill. Adm. Code 840.30(a), (b), (c), (d), (e), (f), (g), (j) and (k)).

(Source: Added at 37 Ill. Reg. 12063, effective July 15, 2013)

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