N2. HAI Surveillance and public reporting
Oral Abstract Submission
Michael Y. Lin, MD, MPH
Associate Professor
Rush University Medical Center
Chicago, IL
Disclosure: CareFusion Foundation (BD): Investigator-initiated grant, Other Financial or Material Support
OpGen: Other Financial or Material Support, Research support in the form of contributed product
Sage Products (now part of Stryker): Other Financial or Material Support, Research support in the form of contributed product
Angela Tang, MPH
Healthcare-Associated Infections Epidemiologist
Illinois Department of Public Health
Chicago, IL
Disclosure: Nothing to disclose
Amy E. Fealy, MPH
Epidemiologist
Hektoen Institute of Medicine
Chicago, IL
Disclosure: Nothing to disclose
George Markovski, BS
Programmer
Cook County Health and Rush University Medical Center
Chicago, IL
Disclosure: Nothing to disclose
Yingxu Xiang, MS
Data Architect
Cook County Health
Clarendon Hills, IL
Disclosure: Nothing to disclose
William Trick, MD
Director
Cook County Health and Rush University Medical Center
Chicago, IL
Disclosure: Nothing to disclose
Background : The Illinois XDRO Registry was created in November 2013 as an information system for XDROs; currently, the registry includes carbapenem-resistant Enterobacteriaceae (CRE), carbapenemase-producing Pseudomonas aeruginosa, and Candida auris. All Illinois healthcare facilities can manually query the registry at time of admission to assess patients’ prior colonization status. A subset of facilities, mainly hospitals, participate in the registry’s automated querying process; alerts are generated automatically and sent via email, page, or text to infection preventionists at the time of patient admission.
Methods :
We assessed counts of XDRO report submissions and total queries (manual and automated) over time, by organism. Facilities achieved automated alerts by sending a near-real-time feed of inpatient admission data (patient name and date of birth) to Illinois Department of Public Health (IDPH) via one of three connection types: direct (data sent directly to IDPH), vendor (data sent via vendor software), and syndromic surveillance (existing syndromic surveillance data adapted for registry).
Results :
6,445 unique patients (11,258 total reports) from 213 facilities have been reported to the XDRO registry (counts by organism type, Table). The registry has been manually queried 39,678 times by 232 facilities. 75 facilities have achieved automation of alerting; the types of data connections used were direct (N=56), vendor (N=18), and syndromic surveillance (N=1). 5,344 automated alerts have been sent for 1,555 unique patients. Automated alerts per month have increased over time (P < 0.001, Figure). Infection preventionists reported feedback on 3,008 CRE alerts via a website questionnaire; among 1176 first alerts/patient/facility, 49% of patients’ XDRO status were previously unknown to the facility, and 33% were not in contact precautions at the time of alert.
Conclusion :
The XDRO registry, originally focused on CRE, successfully expanded to include emerging XDRO threats such as Candida auris and is poised for rapid response to emerging threats. The registry’s adaptable reporting structure and expanding automation has enabled it to deliver an increasing number of actionable infection-control alerts over time.
