Overview

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.

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 Dr. Hira Adil Phone: 312-743-0410
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 Shane Zelencik Phone: 312-744-3434
shane.zelencik@cityofchicago.org

Types of HAIs

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.

Reporting

XDRO Reporting Criteria for Healthcare Facilities in Chicago 
CDPH routinely monitors extensively resistant organisms (XDROs), specifically CRE, C. auris, CP-CRPA and CP-CRAB. For a list of XDRO reporting requirements for healthcare facilities and laboratories, please see table below.
Extensively resistant organism (XDRO) Is this Reportable? Report to
Candida auris, clinical Yes INEDSS
Candida auris, screening Yes INEDSS
CP-CRAB No N/A
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

†  If you do not have access to I-NEDSS please report via encrypted email to the XDRO 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 XDRO 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.

Disease Reporting Criteria for Healthcare Facilities in Chicago
The table below shows reporting requirements for healthcare facilities. There may be a need to report cases and/or outbreaks to multiple entities. Reporting to CDPH does NOT satisfy the need to report to other required entities (e.g. IDPH, INEDSS, NHSN, etc.)
 
Facility Type CDPH Reporting Requirements
Acute Care COVID-19 outbreaks of staff and patients to your assigned IP
iGAS cases to Invasive Group A Strep Case Report Form upon request
Legionella cases to Legionnaires’ Disease Case Reporting Form upon request
All other diseases/conditions email CDPHHAIAR@cityofchicago.org or your assigned IP
Skilled Nursing COVID-19 staff and resident cases to SNF COVID-19 Case Reporting Form
Influenza outbreaks to CDPH Influenza Outbreak Report Form
iGAS cases to Invasive Group A Strep Case Report Form upon request
Legionella cases to Legionnaires’ Disease Case Reporting Form upon request
All other outbreaks email CDPHHAIAR@cityofchicago.org
Assisted Living Influenza outbreaks to CDPH Influenza Outbreak Report Form
All other diseases/conditions to Communicable Disease Reporting Form

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:
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:

Infection Control and Prevention

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:
Multi-Drug Resistant Organisms (MDROs) Guidelines
Indwelling Devices 
Environmental Cleaning
Seasonal Influenza Guidance
Hand Hygiene

Tools and Resources

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
Administrative Code 
  • Notifiable diseases and conditions and control of notifiable diseases and conditions.
Notifiable Disease and Conditions poster 
  • Click this link to download the Illinois Department of Public Health's poster on diseases and conditions that must be reported to local health departments.

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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