Chicago's HAI/AR Unit commits to continued detection and response to antibiotic-resistant infections in healthcare settings.
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.
Below is some essential information from CDC on infections associated with invasive devices and procedures. Additionally, it is important to be aware of specific organisms and diseases often associated with healthcare settings.
MDRO Reporting Criteria for Healthcare Facilities in Chicago
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?
Candida auris, clinical
Candida auris, screening
CP-CRE, KPC or unknown mechanism
CP-CRPA with mechanism
KPC, NDM, VIM, IMP, OXA
Not mandated by the state but CDPH would like reported
CRPA or CP-CRPA with no/unknown mechanism
† If you do not have access to I-NEDSS please report via encrypted email to the MDRO Prevention Epidemiologist (email@example.com) ‡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 (firstname.lastname@example.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.
HAI Reporting Criteria for Healthcare Facilites in Chicago
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:
MRSA Bacteremia (not required for long-term acute care hospitals)
More details on CMS reporting requirements can be found here.
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
The Infection Prevention and Control Assessment and Response (ICAR) tools were developed to assist in assessing infection prevention practices and guide quality improvement activities (e.g., by addressing identified gaps). These tools may also be used by healthcare facilities to conduct internal quality improvement audits. Facilities can schedule an ICAR visit with CDPH, for more information contact the SNFAL project lead or the ACHOO project lead (see contact table in overview).
ICAR Section 1
Select one demographic form based on your individual healthcare setting:
Isolation Guidelines 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
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
For questions related to Healthcare Associated Infection/Antibiotic Resistance, please contact the Chicago Department of Public Health:
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