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.

• 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)

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.

†  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.

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:

• CLABSI
• CAUTI
• SSI
• C. difficile 
• MRSA Bacteremia (not required for long-term acute care hospitals)

More details on CMS reporting requirements can be found here.

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.

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:

• Demographics - Acute Care
• Demographics - Long-Term Care
• Demographics - Outpatient/Ambulatory Care

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

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
• 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

• Hand Hygiene Guidance in Healthcare Settings (CDC)
• Hand Hygiene Program Guide (APIC)
• Speedy Audit App: Hand Hygiene Auditing
• Swipe Sense App: Hand Hygiene Observations

HAN Notifications

• 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

• 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.

Inter-facility Infection Prevention Transfer Form

• 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.

Antibiotic Resistance Threats in the United States 2019

• 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.

COVID-19: U.S. Impact on Antimicrobial Resistance, Special Report 2022

• 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.

Illinois Progress Report

• 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).

HAI Pathogens and Antimicrobial Resistance Report

• 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