On this page: Background | Educational Resources | Setting-Specific Resources | Data & Reporting | Laboratory Testing | Collaborations
Background
Carbapenem-resistant organisms (CRO) are germs that antibiotics don’t work well against. Examples include E. coli, Klebsiella, and Acinetobacter. Carbapenems are strong antibiotics used for serious infections that don’t respond to other medicines. These antibiotics include ertapenem, imipenem, and meropenem. CRO germs are usually spread by direct contact with infected people, especially through wounds or stool. They can cause infections if they enter the body, often through medical devices like ventilators, IVs, urinary catheters, or wounds from injuries or surgery. To prevent these infections, it’s important to follow safety rules, use the right cleaning products, and make sure staff follow infection control practices.
Public Health Response:
VDH works with healthcare facilities to slow the spread of these dangerous organisms. VDH follows the CDC Guidance for a Public Health Response to Contain Novel or Targeted MDROs. Facilities should collaborate with their local health department on response efforts.
Educational Resources
- Carbapenem-Resistant Organisms and Carbapenemase-Producing Organisms: Infection Prevention and Control for Healthcare Facilities (educational booklet)
- Hand Hygiene
- Infection Control Precautions
- Infection Prevention and Control (IPC) - Access the IPC page for comprehensive guidance on infection prevention
- Personal Protective Equipment
- Updated Prevention & Containment Response for Targeted Multidrug-Resistant Organisms in Virginia (slides, recording)
- C. auris and CPO Colonization Screening 101 (slides, recording)
- Simplifying Carbapenem Resistant Organisms (slides, recording)
VDH Infection Prevention and Control Assessments: The HAI/AR team is available to conduct a no-cost, non-regulatory, onsite visit to help a facility identify its infection prevention strengths and areas of opportunity.
- Antimicrobial Resistance and Patient Safety Portal
- Carbapenem-Resistant Acinetobacter (CRAB)
- Carbapenem-Resistant Enterobacterales (CRE)
- Carbapenem-Resistant Pseudomonas aeruginosa (CRPA)
- Project Firstline - check the Education & Training Resource Library for infection prevention and control materials.
Virginia Healthcare-Associated Infections Advisory Group
- Virginia Infection Prevention and Control Training Alliance (VIPTA) - search the education and training resource library for resources related to CROs/CPOs
VCU Virginia Infection Prevention Training Center
- Virginia Infection Prevention Training Center (VIPTC) - courses and trainings related to infection prevention and control
Setting-Specific Resources
CDC Interfacility Transfer Form - The patient transfer form helps make it easier to share information when patients are moved between different places for care. Hospitals and groups focused on making patient safety better can change and use this form to fit their needs.
Carbapenem-resistant organism resources specific to hospital settings:
- Infection Prevention for Acute Care and Long-Term Acute Care Hospitals- CRO/CPO (04/28/2023)
View Hospitals homepage
Carbapenem-resistant organism resources specific to long-term care settings:
Nursing Homes/Skilled Nursing Facilities
Patient Resources
- Acinetobacter Fact Sheet (VDH)
- CRE Website (CDC)
- CRE Fact Sheet (VDH)
- CRPA Fact Sheet (VDH)
- Patient Fact Sheets (VDH)
Data & Reporting
Reporting Requirements
The State Board of Health updated the Virginia Regulations for Disease Reporting and Control (12 VAC 5-90-80) effective November 14, 2018. Carbapenemase-producing organisms (CPOs) was added to the reportable disease list. Carbapenem-resistant Enterobacterales and Carbapenem-resistant Pseudomonas aeruginosa was added to the conditions reportable by directors of laboratories.
Laboratory Testing
- CRO Isolate Testing at DCLS - Information for clinical laboratories submitting CRO isolates to DCLS
Collaborations
The Emergency Department Care Coordination (EDCC) Program, started in 2017, connects healthcare facilities like hospitals and nursing homes across the state. EDCC now includes alerts for Candida auris and other drug-resistant organisms (MDROs). Since these alerts aren’t updated in real-time and only cover patients known to VDH, facilities should share MDRO status when transferring patients. VDH suggests using the CDC Inter-Facility Infection Control Transfer Form for complete MDRO information. Note: The MDRO flags are an extra tool, not a substitute for direct communication.