Healthcare Associated Infections (HAI/AR) - HAN
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Overview
CDPH Healthcare Associated Infections / Antimicrobial Resistance (HAI/AR) Unit
The CDPH HAI/AR Unit conducts onsite investigations and provides technical assistance to Chicago healthcare facilities in order to mitigate gaps in infection prevention and control. The HAI/AR Unit leverages surveillance data for public health responses and trains healthcare staff across the continuum of care in core antimicrobial stewardship principles and appropriate antimicrobial use. The HAI/AR Unit commits to work with state, local, academic, and clinical partners to establish regional standards for infection control and antimicrobial stewardship best practices to reduce the emergence and spread of multi-drug resistant bacteria.
HAI/AR Unit | Project Lead(s) | Contact Information |
---|---|---|
Medical Directors | Dr. Stephanie Black Dr. Do Young Kim |
stephanie.black@cityofchicago.org doyoung.kim@cityofchicago.org |
Projects Administrator | Shane Zelencik | Phone: 312-746-6035 shane.zelencik@cityofchicago.org |
Healthcare Associated Infections (HAI) Coordinator | Hira Adil | Phone: 743-0410 hira.adil@cityofchicago.org |
Skilled Nursing Facilities and Assisted Living (SNFAL) | Liz Shane | Phone: 312-746-6122 elizabeth.shane@cityofchicago.org |
Acute Care Hospital, Outpatient, and Other (ACHOO) | Maria Campos-Bovee | Phone 312-744-3269 maria.campos-bovee@cityofchicago.org |
Epidemiology and Data Management | Kelly Walblay | Phone: 312-744-3376 kelly.walblay@cityofchicago.org |
Antimicrobial Stewardship | Star Cervantes | Phone: 312-744-3376 estrella.cervantes@cityofchicago.org |
Therapeutics and Testing | Christy Zelinski | Phone: 312-746-4023 christy.zelinski@cityofchicago.org |
Project Firstline | Alison VanDine | Phone: 312-742-6716 alison.vandine@cityofchicago.org |
Types of HAIs
- Central Line-associated Bloodstream Infection (CLABSI)
- Catheter-associated Urinary Tract Infections (CAUTI)
- Surgical Site Infection (SSI)
- Ventilator-associated Pneumonia (VAP)
- Specific Diseases and Organisms
- Candida auris (C. auris)
- Clostridioides difficile (C. diff)
- Carbapenem-Resistant Enterobacterales (CRE)
- Carbapenem-Resistant Pseudomonas aeruginosa (CRPA)
- Carbapenem-Resistant Acinetobacter (CRAB)
- Methicillin-resistant Staphylococcus aureus (MRSA)
- Vancomycin Intermediate/Resistant Staphylococcus aureus (VISA/VRSA)
Reporting
CDPH routinely monitors multidrug-resistant organisms (MDROs), specifically CRE, C. auris, CP-CRPA and CP-CRAB. For a list of MDRO reporting requirements for healthcare facilities and laboratories, please see table below.
Multi-drug resistant organism (MDRO) | Is this Reportable? | Report to |
---|---|---|
Candida auris, clinical | Yes | INEDSS† |
Candida auris, screening | Yes | INEDSS† |
CP-CRE, KPC or unknown mechanism | Yes | XDRO |
CP-CRE, non-KPC | Yes | XDRO |
CP-CRPA with mechanism KPC, NDM, VIM, IMP, OXA |
Not mandated by the state but CDPH would like reported | INEDSS† |
CRPA or CP-CRPA with no/unknown mechanism | No | N/A |
CP-CRAB | No‡ | N/A |
† If you do not have access to I-NEDSS please report via encrypted email to the MDRO Prevention Epidemiologist (kelly.walblay@cityofchicago.org)
‡CP-CRAB is not reportable in Illinois, however, please report any clusters of CRAB or individual cases of CRAB with non-OXA mechanisms to CDPH either via INEDSS or email the MDRO Prevention Epidemiologist (kelly.walblay@cityofchicago.org)
**In certain instances, additional information may be requested via a case report form in order to collect epidemiologic data as part of the public health investigation and response. If a case report form is needed, CDPH will reach out.
Certain healthcare-associated infections are required to be reported to the National Healthcare Safety Network (NHSN) by CMS.
Acute care hospitals are required to report the following:
-
CLABSI
-
CAUTI
-
SSI
-
C. difficile
-
MRSA Bacteremia (not required for long-term acute care hospitals)
XDRO Registry
Extensively drug-resistant organisms (XDROs) are a major public health problem because there are no effective drugs currently available to treat infections caused by these bacteria. Detection of these organisms is possible as well as stopping the spread through Admission Screening coupled with consistent Point Prevalence Surveys at Long Term Care and Skilled Nursing facilities. To standardize the monitoring and reporting of these infections among facilities in Illinois, the XDRO registry was created. For access to the XDRO registry, click here.
Infection Control Assessment and Response Tools
ICAR Section 1
Select one demographic form based on your individual healthcare setting:
ICAR Section 2
Below are various assessment modules that cover a variety of infection prevention practices. Modules can be selected based on facility-specific concerns:
- Module 1 – Training, Audits, Feedback
- Module 2 – Hand Hygiene
- Module 3 – Transmission-Based Precautions (TBP)
- Module 4 – Environmental Services (EVS)
- Module 5 – High-level Disinfection and Sterilization
- Module 6 – Injection Safety
- Module 7 – Point of Care (POC) Blood Testing
- Module 8 – Wound Care
- Module 9 – Healthcare Laundry
- Module 10 – Antibiotic Stewardship
Infection Control and Prevention
Transmission-based precautions are an important tier of basic infection control and are to be used in addition to standard precautions to prevent transmission of infectious agents:
- Contact Precautions: Used for patients with known or suspected infections that represent an increased risk for contact transmission. Example Signage
- Droplet Precautions: Used for patients known or suspected to be infected with pathogens transmitted by respiratory droplets that are generated by a patient who is coughing, sneezing, or talking. Example Signage
- Airborne Precautions: Used for patients known or suspected to be infected with pathogens transmitted by the airborne route (e.g., tuberculosis, measles, chickenpox, disseminated herpes zoster). Example Signage
- Enhanced Barrier Precautions (For Skilled Nursing Facilities Only): Indicated when Contact Precautions do not otherwise apply for residents with any of the following wounds or indwelling medical devices (regardless of MDRO colonization status) and/or infection or colonization with an MDRO. Example Signage
- Appendix A: Type and Duration of Precautions Recommended for Selected Infections and Conditions (Updated 9/2018)
- Implementation of Personal Protective Equipment (PPE) Use in Nursing Homes to Prevent Spread of Multidrug-resistant Organisms (MDROs) (Updated 7/12/22)
- Summary of Personal Protective Equipment (PPE) Use and Room Restriction When Caring for Residents in Nursing Homes
Multi-Drug Resistant Organisms (MDROs) Guidelines
- Strategies for Prevention and Response to Novel & Targeted Multidrug-Resistant Organisms (MDROs) (Updated 3/13/23)
- Interim Guidance for a Public Health Response to Contain Novel or Targeted Multidrug-resistant Organisms (MDROs)
Indwelling Devices
- Guidelines for the Prevention of Intravascular Catheter-Related Infections
- Guidelines for Prevention of Catheter-Associated Urinary Tract Infections
Environmental Cleaning
- Best Practices for Environmental Cleaning in Healthcare Facilities
- List P: Antimicrobial Products Registered for use against Candida auris (C.auris)
- List K: Registered Antimicrobial Products Effective against Clostridium difficile Spores
- List N: Disinfectants for Coronavirus (COVID-19)
- Environmental Cleaning Audit Tool
Seasonal Influenza Guidance
- Prevention Strategies for Seasonal Influenza in Health Care Settings: Guidelines and Recommendations
- Interim Guidance for Influenza Outbreak Management in Long-Term Care and Post-Acute Care Facilities
- Guidelines for the Prevention and Control of Influenza Outbreaks in Illinois Long-term Care Facilities
- Influenza Toolkit for Long Term Care Employees
- Influenza Outbreak Report Form for Congregate Settings
Hand Hygiene
Tools and Resources
- The Chicago Health Alert Network (HAN) is CDPH's primary method of sharing information about urgent and emerging public health situations with Chicago healthcare facilities, clinicians, laboratories and partner agencies.
- Project Firstline is a CDC effort that aims to provide engaging, innovative, and effective infection control training for millions of frontline U.S. healthcare workers as well as members of the public health workforce.
- The purpose of the form is to convey information about a patient’s isolation precautions and the reason for their implementation to the receiving facility. The sending facility should record current infection and colonization information. This form is not intended to be a comprehensive documentation of microbiologic history and does not replace a review of medical records and communication between care providers. Please fill out this form and send it with all patients being transferred between healthcare facilities, regardless of whether or not they require isolation.
- The CDC report includes the latest national death and infection estimates for 18 antimicrobial-resistant bacteria and fungi. The germs are listed in three categories-urgent, serious, and concerning-based on level of concern to human health.
- The special report highlights the impact of COVID-19 on antimicrobial resistance in the U.S. the pandemic pushed healthcare facilities, health departments, and communities near their breaking points in 2020, making it very hard to maintain the progress in combating antimicrobial resistance.
- The CDC provides data on reporting general acute care, long term acute care, inpatient rehabilitation facilities, and critical access hospitals by state through the National Healthcare Safety Network (NHSN).
- NHSN’s HAI Pathogens and Antimicrobial Resistance Report provides a national snapshot of common HAI pathogens in U.S. inpatient healthcare facilities and includes national benchmark values for antimicrobial resistance (AR) across 8 urgent and serious drug-resistant phenotypes
HAI Reporting
For questions related to Healthcare Associated Infection/Antibiotic Resistance, please contact the Chicago Department of Public Health:
Hira Adil
email: hira.adil@cityofchicago.org
Phone: 312-743-0410
or
CDPHHAIAR@cityofchicago.org
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A 1:1 collaborative approach to support nursing homes and skilled nursing facilities with implementing a robust Antimicrobial Stewardship Program (ASP) by leveraging acute care hospital (ACH) antimicrobial stewardship (AS) expertise.istration
Jamie Jacob, PharmD, BCIDP
Antimicrobial Stewardship Program Coordinator, IDPH
Jamie.jacob@illinois.gov