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About Antimicrobial Resistance and Multidrug-Resistant Organisms

Antimicrobial resistance (AR) occurs when microorganisms develop or gain the ability to withstand the effects of drug treatments such as antibiotics, which are used to treat bacterial infections. When this happens, healthcare providers are challenged to find other treatments to cure the infection.

When bacteria or fungi become resistant to multiple antibiotics, they are referred to as multidrug-resistant organisms (MDROs) and often have very limited treatment options, if any. These MDROs, or “superbugs”, are spreading worldwide and are a serious risk to public health. Several MDROs have been identified in Los Angeles County healthcare facilities and residents.

Two of the biggest reasons for the emergence and spread of antimicrobial resistance are the overuse and misuse of antibiotics. Please refer to the Antimicrobial Stewardship webpage to learn more about ways to improve antimicrobial use.

Multidrug-Resistant Organisms of Interest

Reporting Instructions

Select MDROs are required to be reported to LACDPH and the California Department of Public Health (CDPH). These include Candida auris, carbapenem-resistant Enterobacterales (CRE), carbapenemase-producing organisms (CPO), vancomycin-resistant Staphylococcus aureus (VRSA), and pan-nonsusceptible organisms.

MDRO Reporting Overview

Who Reports
How to Report
Candida auris (C. auris) Confirmed Candida auris Lab ELR
Provider REDCap or IRIS CRM
Carbapenem-resistant Enterobacterales (CRE)i Enterobacterales that are resistant to one or more carbapenems Provider only NHSN (hospitals) or IRIS CRM (skilled nursing facilities)
Carbapenemase-producing organisms (CPO) Positive phenotypic or molecular test result for carbapenemase productionii Lab only ELRiii
Vancomycin-resistant Staphylococcus aureus (VRSA) S. aureus with a vancomycin MIC 16 Lab only REDCap
Pan-resistant organisms Gram negative bacteria that are non-susceptible to all antibiotics tested Lab only REDCap

iE. coli, Klebsiella oxytoca, Klebsiella pneumoniae, Enterobacter spp.
iiiIf ELR is not fully implemented, please report via REDCap


Reporting Portal and Forms

Additional Compliance Information

Data Dashboards and Reports

To see all of LACDPH dashboards and reports please click this link.

Infection Prevention and Control Guidance

Laboratory Identification and Testing Guidance

Other Resources