Acute Care Hospitals and Skilled Nursing Facilities must report CRE

(UPDATED 1/19/17 11:30 am) LOS ANGELES – The Los Angeles County Interim Health Officer mandates that all acute care hospitals and skilled nursing facilities in the county report carbapenem-resistant Enterobacteriaceae (CRE) cases to the Los Angeles County Department of Public Health (Public Health).

“In order for Public Health to better address the emerging threat of CRE and other multi-drug resistant organisms, I am issuing an order that CRE be reported by all acute care hospitals and skilled nursing facilities in Los Angeles County,” said Jeffrey Gunzenhauser, MD, MPH, Interim Health Officer for Los Angeles County. “Public Health will use this information to prevent the spread of CRE and other antimicrobial resistant organisms by monitoring trends, developing guidance and interventions for healthcare facilities, and by identifying and responding to outbreaks.”

Carbapenem-resistant Enterobacteriaceae are a group of drug- resistant bacteria that cause serious healthcare-associated infections and outbreaks throughout Los Angeles County. CRE infections typically occur in patients in hospitals, nursing homes, and other healthcare settings. Patients whose care requires devices like ventilators, urinary catheters, or intravenous catheters, and patients who are taking long courses of certain antibiotics are most at risk for CRE infections. CRE infections are difficult to treat because they have high levels of resistance to antibiotics. CRE infections have a high mortality rate and are also easily spread between patients in healthcare facilities.

The Health Officer Order also requires that facilities submit an annual antibiogram documenting drug-resistance for CRE and other bacterial pathogens. Antibiograms offer additional information on overall resistance trends in facilities that will be aggregated across the county to identify geographic areas that may have higher resistance, and need assistance from public health to address these rates. In addition to CRE, Public Health monitors several types of healthcare associated infections, tracks data on antimicrobial resistance patterns across the County, and evaluates infection control practices and addressing identified gaps.

The cities of Long Beach and Pasadena will issue similar orders regarding CRE reporting.

"Reporting CRE in Long Beach is an important step in preventing healthcare associated infections and antibiotic resistance, and allows the City to ensure adequate infection control practices,” said Anissa Davis, MD, MPH, Health Officer, City of Long Beach. “We welcome the opportunity to partner with the County of Los Angeles to provide consistency in reporting throughout our county’s healthcare facilities.”

“The Pasadena Public Health Department is pleased to join forces with our neighboring public health jurisdictions to better understand antimicrobial resistance in our communities and identify ways to address this growing public health problem,” said Ying-Ying Goh, MD, MSHS, Pasadena Health Officer.

For more information on CRE reporting, visit the Public Health website: publichealth.lacounty.gov/acd/Diseases/CRE.htm.

The Department of Public Health is committed to protecting and improving the health of the nearly 10 million residents of Los Angeles County. Through a variety of programs, community partnerships and services, Public Health oversees environmental health, disease control, and community and family health. Public Health comprises nearly 4,000 employees and has an annual budget exceeding $900 million. To learn more about the LA County Department of Public Health and the work they do, visit PublicHealth.LACounty.gov, and follow Public Health on social media at twitter.com/LAPublicHealth, facebook.com/LAPublicHealth, and youtube.com/LAPublicHealth.

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