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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*
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]

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
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.

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