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1. Carbapenem-Resistant and Extended-Spectrum [beta]-Lactamase-Producing Enterobacterales in Children, United States, 2016-2020

Author

Grome, Heather N., Grass, Julian E., Duffy, Nadezhda, Bulens, Sandra N., Ansari, Uzma, Campbell, Davina, Lutgring, Joseph D., Gargis, Amy S., Masters, Thao, Kent, Alyssa G., McKay, Susannah L., Smith, Gillian, Wilson, Lucy E., Vaeth, Elisabeth, Evenson, Bailey, Dumyati, Ghinwa, Tsay, Rebecca, Phipps, Erin, Flores, Kristina, Wilson, Christopher D., Czaja, Christopher A., Johnston, Helen, Janelle, Sarah J., Lynfield, Ruth, OMalley, Sean, Vagnone, Paula Snippes, Maloney, Meghan, Nadle, Joelle, and Guh, Alice Y.

Subjects
Medical research, Medicine, Experimental, Enterobacteriaceae infections -- Drug therapy -- Diagnosis, Drug resistance in microorganisms -- Testing, Communicable diseases in children -- Drug therapy -- Diagnosis, Health
Abstract

Medscape CME Activity In support of improving patient care, this activity has been planned and implemented by Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is jointly accredited with commendation [...]

Published
2024
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2. Carbapenem-resistant Acinetobacter baumannii complex in the United States—An epidemiological and molecular description of isolates collected through the Emerging Infections Program, 2019

Author

Bulens, Sandra N., Campbell, Davina, McKay, Susannah L., Vlachos, Nicholas, Burgin, Alex, Burroughs, Mark, Padila, Jasmine, Grass, Julian E., Jacob, Jesse T., Smith, Gillian, Muleta, Daniel B., Maloney, Meghan, Macierowski, Bobbie, Wilson, Lucy E., Vaeth, Elisabeth, Lynfield, Ruth, O’Malley, Sean, Snippes Vagnone, Paula M., Dale, Jennifer, Janelle, Sarah J., Czaja, Christopher A., Johnson, Helen, Phipps, Erin C., Flores, Kristina G., Dumyati, Ghinwa, Tsay, Rebecca, Beldavs, Zintars G., Maureen Cassidy, P., Hall, Amanda, Walters, Maroya S., Guh, Alice Y., Magill, Shelley S., and Lutgring, Joseph D.

Published
2024
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3. Carbapenem-Resistant and Extended-Spectrum β-Lactamase-Producing Enterobacterales in Children, United States, 2016-2020.

Author

Grome, Heather N., Grass, Julian E., Duffy, Nadezhda, Bulens, Sandra N., Ansari, Uzma, Campbell, Davina, Lutgring, Joseph D., Gargis, Amy S., Masters, Thao, Kent, Alyssa G., McKay, Susannah L., Smith, Gillian, Wilson, Lucy E., Vaeth, Elisabeth, Evenson, Bailey, Dumyati, Ghinwa, Tsay, Rebecca, Phipps, Erin, Flores, Kristina, and Wilson, Christopher D.

Subjects
CHILD patients, AGE groups, URINE, INFANTS
Abstract

We conducted surveillance for carbapenem-resistant Enterobacterales (CRE) during 2016-2020 at 10 US sites and extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) during 2019-2020 at 6 US sites. Among 159 CRE cases in children (median age 5 years), CRE was isolated from urine for 131 (82.4%) and blood from 20 (12.6%). Annual CRE incidence rate (cases/100,000 population) was 0.47-0.87. Among 207 ESBLE cases in children (median age 6 years), ESBL-E was isolated from urine of 196 (94.7%) and blood of 8 (3.9%). Annual ESBL-E incidence rate was 26.5 in 2019 and 19.63 in 2020. CRE and ESBL-E rates were >2-fold higher among infants than other age groups. Most CRE and ESBL-E cases were healthcare-associated community-onset (68 [43.0%] for CRE vs. 40 [23.7%] for ESBL-E) or community- associated (43 [27.2%] for CRE vs. 109 [64.5%] for ESBL-E). Programs to detect, prevent, and treat multidrugresistant infections must include pediatric populations (particularly the youngest) and outpatient settings. [ABSTRACT FROM AUTHOR]

Published
2024
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4. Trends in Incidence of Carbapenem-Resistant Enterobacterales in 7 US Sites, 2016─2020

Author

Duffy, Nadezhda, primary, Li, Rongxia, additional, Czaja, Christopher A, additional, Johnston, Helen, additional, Janelle, Sarah J, additional, Jacob, Jesse T, additional, Smith, Gillian, additional, Wilson, Lucy E, additional, Vaeth, Elisabeth, additional, Lynfield, Ruth, additional, O’Malley, Sean, additional, Vagnone, Paula Snippes, additional, Dumyati, Ghinwa, additional, Tsay, Rebecca, additional, Bulens, Sandra N, additional, Grass, Julian E, additional, Pierce, Rebecca, additional, Cassidy, P Maureen, additional, Hertzel, Heather, additional, Wilson, Christopher, additional, Muleta, Daniel, additional, Taylor, Jacquelyn, additional, and Guh, Alice Y, additional

Published
2023
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5. 1932. Molecular Epidemiology of NDM-producing Acinetobacter baumannii in the US—October 2013—March 2022

Author

Medrzycki, Magdalena, primary, Stanton, Richard A, additional, Rankin, Danielle A, additional, Horwich-Scholefield, Sam, additional, Mahmud, Arif, additional, Maruca, Tyler, additional, Brister, Sarah, additional, Hsiao, Lian, additional, Vaeth, Elisabeth, additional, Therrien, Michelle, additional, Young, Erin L, additional, Oakeson, Kelly F, additional, Haque, Farhana, additional, Neff, Lindsay, additional, Halpin, Alison L, additional, Tran, Michael, additional, Veliz, Kirstin L, additional, Hua, Chi, additional, Schneider, Emily C, additional, and Maroya, Walters, additional

Published
2023
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7. 1928. Trends In Incidence of Carbapenem-Resistant Enterobacterales (CRE) In Seven US sites, 2016─2020

Author

Duffy, Nadezhda, primary, Li, Rongxia, additional, Czaja, Christopher A, additional, Johnston, Helen, additional, Janelle, Sarah J, additional, Jacob, Jesse T, additional, Smith, Gillian, additional, Wilson, Lucy E, additional, Vaeth, Elisabeth, additional, Dumyati, Ghinwa, additional, Tsay, Rebecca, additional, Wilson, Christopher, additional, Muleta, Daniel, additional, Mounsey, Jacquelyn, additional, Lynfield, Ruth, additional, O’Malley, Sean, additional, Vagnone, Paula S, additional, Pierce, Rebecca, additional, Cassidy, P Maureen, additional, Hertzel, Heather, additional, Bulens, Sandra N, additional, Grass, Julian E, additional, and Guh, Alice, additional

Published
2023
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8. 2458. Carbapenem-resistant Acinetobacter baumannii complex infections and SARS-CoV-2 positivity in 9 U.S. sites, 2020-2022

Author

Bulens, Sandra N, primary, Hall, Amanda, additional, Jacob, Jesse T, additional, Smith, Gillian, additional, Wilson, Lucy E, additional, Vaeth, Elisabeth, additional, Wilson, Christopher, additional, Muleta, Daniel, additional, Dumyati, Ghinwa, additional, Tsay, Rebecca, additional, Maloney, Meghan, additional, Stabach, Nicole, additional, Lynfield, Ruth, additional, O’Malley, Sean, additional, Pierce, Rebecca, additional, Hertzel, Heather, additional, Czaja, Christopher A, additional, Johnston, Helen, additional, Grass, Julian E, additional, Brandenburg, Joshua, additional, Guh, Alice, additional, and Magill, Shelley, additional

Published
2023
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9. 970. Assessing the burden of Acinetobacter baumannii and Candida auris among ventilated patients in Maryland: A statewide period prevalence survey of two urgent threats

Author

Harris, Anthony, primary, Pineles, Lisa, additional, Kristie Johnson, J, additional, O’Hara, Lyndsay M, additional, Smith, Lauren Leigh, additional, French, Indira, additional, Rubin, Jamie, additional, Perlmutter, Rebecca, additional, Heller, Ashley, additional, Klein, Liore, additional, Blythe, David, additional, and Vaeth, Elisabeth, additional

Published
2023
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10. Prevalence of Acinetobacter baumannii and Candida auris in Patients Receiving Mechanical Ventilation

Author

Harris, Anthony D., primary, Pineles, Lisa, additional, Johnson, J. Kristie, additional, O’Hara, Lyndsay M., additional, Smith, L. Leigh, additional, French, Indira, additional, Rubin, Jamie, additional, Perlmutter, Rebecca, additional, Heller, Ashley, additional, Klein, Liore, additional, Thoguru, John, additional, Blythe, David, additional, and Vaeth, Elisabeth, additional

Published
2023
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12. Epidemiology of carbapenem-resistant and extended-spectrum beta-lactamase-producing Enterobacterales in US children, 2016–2020

Author

Grome, Heather, primary, Grass, Julian, additional, Duffy, Nadezhda, additional, Bulens, Sandra, additional, Jacob, Jesse, additional, Smith, Gillian, additional, Wilson, Lucy, additional, Vaeth, Elisabeth, additional, Evenson, Bailey, additional, Dumyati, Ghinwa, additional, Tsay, Rebecca, additional, Phipps, Erin C., additional, Flores, Kristina, additional, Wilson, Christopher, additional, Czaja, Christopher, additional, Johnston, Helen, additional, Lynfield, Ruth, additional, O’Malley, Sean, additional, Maloney, Meghan, additional, Stabach, Nicole, additional, Nadle, Joelle, additional, and Guh, Alice, additional

Published
2023
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13. Carbapenem-Resistant enterobacterales in individuals with and without health care risk factors —Emerging infections program, United States, 2012-2015

Author

Bulens, Sandra N., primary, Reses, Hannah E., additional, Ansari, Uzma A., additional, Grass, Julian E., additional, Carmon, Clayton, additional, Albrecht, Valerie, additional, Lawsin, Adrian, additional, McAllister, Gillian, additional, Daniels, Jonathan, additional, Lee, Yeon-Kyeng, additional, Yi, Sarah, additional, See, Isaac, additional, Jacob, Jesse T., additional, Bower, Chris W., additional, Wilson, Lucy, additional, Vaeth, Elisabeth, additional, Lynfield, Ruth, additional, Vagnone, Paula Snippes, additional, Shaw, Kristin M., additional, Dumyati, Ghinwa, additional, Tsay, Rebecca, additional, Phipps, Erin C., additional, Bamberg, Wendy, additional, Janelle, Sarah J., additional, Beldavs, Zintars G., additional, Cassidy, P. Maureen, additional, Kainer, Marion, additional, Muleta, Daniel, additional, Mounsey, Jacquelyn T., additional, Laufer-Halpin, Alison, additional, Karlsson, Maria, additional, Lutgring, Joseph D., additional, and Walters, Maroya Spalding, additional

Published
2023
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14. 86. Antibiotic-resistant gram-negative bacterial infections among persons with or without a prior positive test for SARS-CoV-2 in 10 U.S. sites, 2020

Author

Bulens, Sandra N, primary, Grass, Julian E, additional, Duffy, Nadezhda, additional, Tola, Jigsa, additional, Jacob, Jesse T, additional, Smith, Gillian, additional, Vaeth, Elisabeth, additional, Dumyati, Ghinwa, additional, Looi, Hsioa Che, additional, Phipps, Erin C, additional, Flores, Kristina, additional, Wilson, Christopher, additional, Muleta, Daniel, additional, Czaja, Christopher A, additional, Driscoll, Jennifer, additional, Lynfield, Ruth, additional, O'Malley, Sean M, additional, Maloney, Meghan, additional, Stabach, Nicole, additional, Nadle, Joelle, additional, Pierce, Rebecca, additional, Hertzel, Heather, additional, and Guh, Alice, additional

Published
2022
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15. Carbapenem-resistant Acinetobacter baumannii and Carbapenem-resistant Enterobacterales in US Dialysis Populations, 2016-2021.

Author

Gomes, Danica, Grass, Julian, Bulens, Sandra, Duffy, Nadezhda, Brandenburg, Joshua, Jacob, Jesse, Smith, Gillian, Vaeth, Elisabeth, Dumyati, Ghinwa, Flores, Kristina, Wilson, Christopher, Muleta, Daniel, Czaja, Christopher, Johnston, Helen, Lynfield, Ruth, Snippes Vagnone, Paula, O'Malley, Sean, Stabach, Nicole, Nadle, Joelle, and Pierce, Rebecca

Published
2024
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16. Whole-Genome Sequencing Reveals Diversity of Carbapenem-Resistant Pseudomonas aeruginosa Collected through CDC’s Emerging Infections Program, United States, 2016–2018

Author

Stanton, Richard A., primary, Campbell, Davina, additional, McAllister, Gillian A., additional, Breaker, Erin, additional, Adamczyk, Michelle, additional, Daniels, Jonathan B., additional, Lutgring, Joseph D., additional, Karlsson, Maria, additional, Schutz, Kyle, additional, Jacob, Jesse T., additional, Wilson, Lucy E., additional, Vaeth, Elisabeth, additional, Li, Linda, additional, Lynfield, Ruth, additional, Snippes Vagnone, Paula M., additional, Phipps, Erin C., additional, Hancock, Emily B., additional, Dumyati, Ghinwa, additional, Tsay, Rebecca, additional, Cassidy, P. Maureen, additional, Mounsey, Jacquelyn, additional, Grass, Julian E., additional, Bulens, Sandra N., additional, Walters, Maroya Spalding, additional, and Halpin, Alison Laufer, additional

Published
2022
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17. Improved phenotype-based definition for identifying carbapenemase producers among carbapenem-resistant Enterobacteriaceae

Author

Chea, Nora, Bulens, Sandra N., Kongphet-Tran, Thiphasone, Lynfield, Ruth, Shaw, Kristin M., Vagnone, Paula Snippes, Kainer, Marion A., Muleta, Daniel B., Wilson, Lucy, Vaeth, Elisabeth, Dumyati, Ghinwa, Concannon, Cathleen, Phipps, Erin C., Culbreath, Karissa, Janelle, Sarah J., Bamberg, Wendy M., Guh, Alice Y., Limbago, Brandi, and Kallen, Alexander J.

Subjects
Carbapenems -- Research -- Identification and classification, Phenotypes -- Analysis, Health
Abstract

Multidrug-resistant organisms are a major public health concern worldwide (1-4). Of particular concern has been the emergence of resistance to carbapenem antimicrobial drugs among Enterobacteriaceae (4,5). In the United States, [...]

Published
2015
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18. Epidemiology of Carbapenem-Resistant Enterobacteriaceae in 7 US Communities, 2012-2013

Author

Guh, Alice Y., Bulens, Sandra N., Mu, Yi, Jacob, Jesse T., Reno, Jessica, Scott, Janine, Wilson, Lucy E., Vaeth, Elisabeth, Lynfield, Ruth, Shaw, Kristin M., Vagnone, Paula M. Snippes, Bamberg, Wendy M., Janelle, Sarah J., Dumyati, Ghinwa, Concannon, Cathleen, Beldavs, Zintars, Cunningham, Margaret, Cassidy, P. Maureen, Phipps, Erin C., Kenslow, Nicole, Travis, Tatiana, Lonsway, David, Rasheed, J. Kamile, Limbago, Brandi M., and Kallen, Alexander J.

Published
2015
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19. Carbapenemase production among less-common Enterobacterales genera: 10 US sites, 2018

Author

Shugart, Alicia, primary, Mahon, Garrett, additional, Huang, Jennifer Y, additional, Karlsson, Maria, additional, Valley, Ann, additional, Lasure, Megan, additional, Gross, Annastasia, additional, Pattee, Brittany, additional, Vaeth, Elisabeth, additional, Brooks, Richard, additional, Maruca, Tyler, additional, Dominguez, Catherine E, additional, Torpey, David, additional, Francis, Drew, additional, Bhattarai, Rachana, additional, Kainer, Marion A, additional, Chan, Allison, additional, Dubendris, Heather, additional, Greene, Shermalyn R, additional, Blosser, Sara J, additional, Shannon, D J, additional, Jones, Kelly, additional, Brennan, Brenda, additional, Hun, Sopheay, additional, D’Angeli, Marisa, additional, Murphy, Caitlin N, additional, Tierney, Maureen, additional, Reese, Natashia, additional, Bhatnagar, Amelia, additional, Kallen, Alex, additional, Brown, Allison C, additional, and Spalding Walters, Maroya, additional

Published
2021
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20. Carbapenem-Resistant Acinetobacter baumannii Incidence Trends Identified Through the Emerging Infections Program, 2012–2018

Author

Bulens, Sandra, primary, Kazakova, Sophia, additional, Reses, Hannah E., additional, Yi, Sarah, additional, Baggs, James, additional, Jacob, Jesse, additional, Bower, Chris, additional, Vaeth, Elisabeth, additional, Kainer, Marion, additional, Mounsey, Jacquelyn, additional, Muleta, Daniel, additional, Bamberg, Wendy, additional, Johnston, Helen, additional, Witwer, Medora, additional, Maloney, Meghan, additional, Dumyati, Ghinwa, additional, Stabach, Nicole, additional, Pierce, Rebecca, additional, Hancock, Emily, additional, and Walters, Maroya, additional

Published
2020
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21. Identification of Colonized Patients During an Outbreak of Candida auris Using a Regional Health Information Exchange

Author

Brooks, Richard, primary, Vaeth, Elisabeth, additional, Saunders, Heather, additional, Blood, Tim, additional, Grace, Brittany, additional, Blythe, David, additional, Klein, Liore, additional, Reuben, Jacqueline, additional, Trappler, Regan, additional, Iyengar, Preetha, additional, Blake, Emily, additional, Lineberger, Sarah, additional, Abdelfattah, Rehab, additional, Tully, Kathleen, additional, Forsberg, Kaitlin, additional, Walters, Maroya, additional, and Vallabhaneni, Snigdha, additional

Published
2020
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22. Characteristics Associated with Death in Patients with Carbapenem-Resistant Acinetobacter baumannii, United States, 2012–2017

Author

Reses, Hannah E., primary, Hatfield, Kelly, additional, Jacob, Jesse, additional, Bower, Chris, additional, Vaeth, Elisabeth, additional, Mounsey, Jacquelyn, additional, Muleta, Daniel, additional, Witwer, Medora, additional, Dumyati, Ghinwa, additional, Hancock, Emily, additional, Baggs, James, additional, Walters, Maroya, additional, and Bulens, Sandra, additional

Published
2020
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23. Whole-Genome Sequencing Reveals Diversity of Carbapenem-Resistant Pseudomonas aeruginosa Collected Through the Emerging Infections Program

Author

Stanton, Richard, primary, Daniels, Jonathan, additional, Breaker, Erin, additional, Campbell, Davina, additional, Lutgring, Joseph, additional, Karlsson, Maria, additional, Schutz, Kyle, additional, Jacob, Jesse, additional, Wilson, Lucy, additional, Vaeth, Elisabeth, additional, Li, Linda, additional, Lynfield, Ruth, additional, Phipps, Erin C., additional, Hancock, Emily, additional, Dumyati, Ghinwa, additional, Tsay, Rebecca, additional, Cassidy, P. Maureen, additional, Mounsey, Jacquelyn, additional, Grass, Julian, additional, Walters, Maroya, additional, and Halpin, Alison, additional

Published
2020
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24. Evaluation of Discrepancies in Carbapenem Minimum Inhibitory Concentrations Obtained at Clinical Laboratories Compared to a Public Health Laboratory

Author

Grass, Julian E., primary, Magill, Shelley S., additional, See, Isaac, additional, Ansari, Uzma, additional, Wilson, Lucy E., additional, Vaeth, Elisabeth, additional, Vagnone, Paula Snippes, additional, Pattee, Brittany, additional, Jacob, Jesse T., additional, Program, Georgia Emerging Infections, additional, Bower, Chris, additional, Center, Atlanta Veterans Affairs Medical, additional, Research, Foundation for Atlanta Veterans Education and, additional, Satola, Sarah W., additional, Janelle, Sarah J., additional, Schutz, Kyle, additional, Tsay, Rebecca, additional, Kainer, Marion A., additional, Muleta, Daniel, additional, Cassidy, P. Maureen, additional, Leung, Vivian H., additional, Maloney, Meghan, additional, Phipps, Erin C., additional, Program, New Mexico Emerging Infections, additional, Flores, Kristina G., additional, Epson, Erin, additional, Nadle, Joelle, additional, Karlsson, Maria, additional, and Lutgring, Joseph D., additional

Published
2020
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25. Characterization of Ceftazidime-Avibactam-Resistant Carbapenem-Resistant Enterobacteriaceae, United States, 2015–2017

Author

Ansari, Uzma, primary, Reses, Hannah E., additional, Grass, Julian, additional, Nadle, Joelle, additional, Bower, Chris, additional, Jacob, Jesse, additional, Vaeth, Elisabeth, additional, Witwer, Medora, additional, Hancock, Emily, additional, Dale, Suzanne, additional, Dumyati, Ghinwa, additional, Beldavs, Zintars, additional, Muleta, Daniel, additional, Duffy, Nadezhda, additional, See, Isaac, additional, and Lutgring, Joseph, additional

Published
2020
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26. Epidemiology of carbapenem-resistant and extended-spectrum beta-lactamase-producing Enterobacterales in US children, 2016–2020.

Author

Grome, Heather, Grass, Julian, Duffy, Nadezhda, Bulens, Sandra, Jacob, Jesse, Smith, Gillian, Wilson, Lucy, Vaeth, Elisabeth, Evenson, Bailey, Dumyati, Ghinwa, Tsay, Rebecca, Phipps, Erin C., Flores, Kristina, Wilson, Christopher, Czaja, Christopher, Johnston, Helen, Lynfield, Ruth, O'Malley, Sean, Maloney, Meghan, and Stabach, Nicole

Published
2024
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28. 2449. Early Detection of Candida auris is Essential to Control Spread: Four Effective Active Surveillance Strategies

Author

Vallabhaneni, Snigdha, primary, Zahn, Matthew, additional, Epson, Erin, additional, ODonnell, Kathleen, additional, Horwich-Scholefield, Sam, additional, Brooks, Richard, additional, Vaeth, Elisabeth, additional, Blood, Timothy, additional, Shannon, D J, additional, Feaster, Christine, additional, Leung, Vivian, additional, Maloney, Meghan, additional, Forsberg, Kaitlin, additional, Kallen, Alexander, additional, Jackson, Brendan R, additional, and Walters, Maroya S, additional

Published
2019
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29. 507. Epidemiology of Community-Associated Carbapenemase + Producing Carbapenem-Resistant Enterobacteriacae Identified from the Emerging Infections Program, 2012–2017

Author

See, Isaac, primary, Ansari, Uzma, additional, Reses, Hannah, additional, Grass, Julian E, additional, Epson, Erin, additional, Nadle, Joelle, additional, Bamberg, Wendy M, additional, Janelle, Sarah J, additional, Bower, Chris W, additional, Jacob, Jesse T, additional, Vaeth, Elisabeth, additional, Wilson, Lucy E, additional, Lynfield, Ruth, additional, VonBank, Brittany, additional, Snippes Vagnone, Paula, additional, Hancock, Emily B, additional, Phipps, Erin C, additional, Dumyati, Ghinwa, additional, Tsay, Rebecca, additional, Cassidy, Maureen, additional, Kainer, Marion A, additional, Mounsey, Jacquelyn, additional, Muleta, Daniel, additional, Bulens, Sandra N, additional, Karlsson, Maria, additional, Duffy, Nadezhda, additional, and Lutgring, Joseph, additional

Published
2019
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30. 486. Epidemiology of Carbapenem-Resistant Pseudomonas aeruginosa Identified through the Emerging Infections Program (EIP), United States, 2016–2018

Author

Grass, Julian E, primary, Bulens, Sandra N, additional, Bamberg, Wendy M, additional, Janelle, Sarah J, additional, Schutz, Kyle, additional, Jacob, Jesse T, additional, Bower, Chris W, additional, Blakney, Rebekah, additional, Wilson, Lucy E, additional, Vaeth, Elisabeth, additional, Li, Linda, additional, Lynfield, Ruth, additional, Snippes Vagnone, Paula, additional, Dobbins, Ginette, additional, Phipps, Erin C, additional, Hancock, Emily B, additional, Dumyati, Ghinwa, additional, Tsay, Rebecca, additional, Cassidy, P Maureen, additional, West, Nicole, additional, Kainer, Marion A, additional, Mounsey, Jacquelyn, additional, Stanton, Richard A, additional, McAllister, Gillian A, additional, Campbell, Davina, additional, Lutgring, Joseph D, additional, Karlsson, Maria, additional, and Walters, Maroya S, additional

Published
2019
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33. 1162. Epidemiology of Carbapenem-Resistant Pseudomonas aeruginosa Identified Through the Emerging Infections Program (EIP), United States, 2016–2017

Author

Grass, Julian, primary, Bulens, Sandra, additional, Bamberg, Wendy, additional, Janelle, Sarah J, additional, Stendel, Patrick, additional, Jacob, Jesse T, additional, Bower, Chris, additional, Sukumaran, Stephen, additional, Wilson, Lucy E, additional, Vaeth, Elisabeth, additional, Li, Linda, additional, Lynfield, Ruth, additional, Vagnone, Paula Snippes, additional, Dobbins, Ginette, additional, Phipps, Erin C, additional, Hancock, Emily B, additional, Dumyati, Ghinwa, additional, Tsay, Rebecca, additional, Pierce, Rebecca, additional, Cassidy, P Maureen, additional, West, Nicole, additional, Kainer, Marion A, additional, Muleta, Daniel, additional, Mounsey, Jacquelyn, additional, Campbell, Davina, additional, Stanton, Richard, additional, Karlsson, Maria S, additional, and Walters, Maroya Spalding, additional

Published
2018
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34. 1761. Effect of Carbapenem-Resistant Enterobacteriaceae (CRE) Surveillance Case Definition Change on CRE Epidemiology—Selected US Sites, 2015–2016

Author

Duffy, Nadezhda, primary, Bulens, Sandra N, additional, Reses, Hannah, additional, Karlsson, Maria S, additional, Ansari, Uzma, additional, Bamberg, Wendy, additional, Janelle, Sarah J, additional, Jacob, Jesse T, additional, Bower, Chris, additional, Wilson, Lucy E, additional, Vaeth, Elisabeth, additional, Lynfield, Ruth, additional, Witwer, Medora, additional, Phipps, Erin C, additional, Dumyati, Ghinwa, additional, Pierce, Rebecca, additional, Cassidy, P Maureen, additional, Kainer, Marion A, additional, Muleta, Daniel, additional, and See, Isaac, additional

Published
2018
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36. Carbapenem-Nonsusceptible Acinetobacter baumannii, 8 US Metropolitan Areas, 2012–2015

Author

Bulens, Sandra N., primary, Yi, Sarah H., additional, Walters, Maroya S., additional, Jacob, Jesse T., additional, Bower, Chris, additional, Reno, Jessica, additional, Wilson, Lucy, additional, Vaeth, Elisabeth, additional, Bamberg, Wendy, additional, Janelle, Sarah J., additional, Lynfield, Ruth, additional, Vagnone, Paula Snippes, additional, Shaw, Kristin, additional, Kainer, Marion, additional, Muleta, Daniel, additional, Mounsey, Jacqueline, additional, Dumyati, Ghinwa, additional, Concannon, Cathleen, additional, Beldavs, Zintars, additional, Cassidy, P. Maureen, additional, Phipps, Erin C., additional, Kenslow, Nicole, additional, Hancock, Emily B., additional, and Kallen, Alexander J., additional

Published
2018
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38. Wide Range of Carbapenem-resistant Enterobacteriaceae Incidence and Trends in Emerging Infections Program Surveillance, 2012–2015

Author

Duffy, Nadezhda, primary, Brown, Cedric J, additional, Bulens, Sandra N, additional, Bamberg, Wendy, additional, Janelle, Sarah J, additional, Jacob, Jesse T, additional, Bower, Chris, additional, Wilson, Lucy, additional, Vaeth, Elisabeth, additional, Lynfield, Ruth, additional, Vagnone, Paula Snippes, additional, Phipps, Erin C, additional, Hancock, Emily B, additional, Dumyati, Ghinwa, additional, Concannon, Cathleen, additional, Beldavs, Zintars G, additional, Cassidy, P Maureen, additional, Kainer, Marion, additional, Muleta, Daniel, additional, and See, Isaac, additional

Published
2017
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40. Treatment of Carbapenem-Resistant Enterobacteriaceae (CRE) in 6 US communities

Author

Bower, Chris, primary, Reddy, Sujan C., additional, Wilson, Lucy, additional, Vaeth, Elisabeth, additional, Dumyati, Ghinwa, additional, Concannon, Cathleen, additional, Phipps, Erin C., additional, Kenslow, Nicole, additional, Kainer, Marion, additional, Muleta, Daniel, additional, Mounsey, Jacquelyn, additional, Bamberg, Wendy, additional, Janelle, Sarah J., additional, Badolato, Elizabeth, additional, Reno, Jessica, additional, and Jacob, Jesse T., additional

Published
2016
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41. 1800Phenotypic Definitions for Identifying Carbapenemase-Producing Carbapenem-resistant Enterobacteriaceae

Author

Chea, Nora, primary, Bulens, Sandra N., additional, Kongphet-Tran, Thiphasone, additional, Albrecht, Valerie, additional, Lynfield, Ruth, additional, Shaw, Kristin M, additional, Kainer, Marion, additional, Muleta, Daniel, additional, Wilson, Lucy, additional, Vaeth, Elisabeth, additional, Dumyati, Ghinwa, additional, Concannon, Cathleen, additional, Phipps, Erin C., additional, Culbreath, Karissa, additional, Janelle, Sarah Jackson, additional, Bamberg, Wendy, additional, and Kallen, Alexander, additional

Published
2014
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43. Whole-Genome Sequencing Reveals Diversity of Carbapenem-Resistant Pseudomonas aeruginosaCollected Through the Emerging Infections Program

Author

Stanton, Richard, Daniels, Jonathan, Breaker, Erin, Campbell, Davina, Lutgring, Joseph, Karlsson, Maria, Schutz, Kyle, Jacob, Jesse, Wilson, Lucy, Vaeth, Elisabeth, Li, Linda, Lynfield, Ruth, Phipps, Erin C., Hancock, Emily, Dumyati, Ghinwa, Tsay, Rebecca, Cassidy, P. Maureen, Mounsey, Jacquelyn, Grass, Julian, Walters, Maroya, and Halpin, Alison

Abstract

Background:Carbapenem-resistant Pseudomonas aeruginosa(CRPA) is a frequent cause of healthcare-associated infections (HAIs). The CDC Emerging Infections Program (EIP) conducted population and laboratory-based surveillance of CRPA in selected areas in 8 states from August 1, 2016, through July 31, 2018. We aimed to describe the molecular epidemiology and mechanisms of resistance of CRPA isolates collected through this surveillance. Methods:We defined a case as the first isolate of P. aeruginosaresistant to imipenem, meropenem, or doripenem from the lower respiratory tract, urine, wounds, or normally sterile sites identified from a resident of the EIP catchment area in a 30-day period; EIP sites submitted a systematic random sample of isolates to CDC for further characterization. Of 1,021 CRPA clinical isolates submitted, 707 have been sequenced to date using an Illumina MiSeq. Sequenced genomes were classified using the 7-gene multilocus sequence typing (MLST) scheme, and a core genome MLST (cgMLST) scheme was used to determine phylogeny. Antimicrobial resistance genes were identified using publicly available databases, and chromosomal mechanisms of carbapenem resistance were determined using previously validated genetic markers. Results:There were 189 sequence types (STs) among the 707 sequenced genomes (Fig. 1). The most frequently occurring were high-risk clones ST235 (8.5%) and ST298 (4.7%), which were found across all EIP sites. Carbapenemase genes were identified in 5 (<1%) isolates. Overall, 95.6% of the isolates had chromosomal mutations associated with carbapenem resistance: 93.2% had porinD-associated mutations that decrease membrane permeability to the drugs; 24.8% had mutations associated with overexpression of the multidrug efflux pump MexAB-OprM; and 22.9% had mutations associated with overexpression of the endogenous β-lactamase ampC. More than 1 such chromosomal resistance mutation type was present in 37.8% of the isolates. Conclusions:The diversity of the sequence types demonstrates that HAIs caused by CRPA can arise from a variety of strains and that high-risk clones are broadly disseminated across the EIP sites but are a minority of CRPA strains overall. Carbapenem resistance in P. aeruginosawas predominantly driven by chromosomal mutations rather than acquired mechanisms (ie, carbapenemases). The diversity of the CRPA isolates and the lack of carbapenemase genes suggest that this ubiquitous pathogen can readily evolve chromosomal resistance mechanisms, but unlike carbapenemases, these cannot be easily spread through horizontal transfer.Funding:NoneDisclosures:None

Published
2020
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44. Carbapenem-Resistant Acinetobacter baumanniiIncidence Trends Identified Through the Emerging Infections Program, 2012–2018

Author

Bulens, Sandra, Kazakova, Sophia, Reses, Hannah E., Yi, Sarah, Baggs, James, Jacob, Jesse, Bower, Chris, Vaeth, Elisabeth, Kainer, Marion, Mounsey, Jacquelyn, Muleta, Daniel, Bamberg, Wendy, Johnston, Helen, Witwer, Medora, Maloney, Meghan, Dumyati, Ghinwa, Stabach, Nicole, Pierce, Rebecca, Hancock, Emily, and Walters, Maroya

Abstract

Background:Carbapenem-resistant Acinetobacter baumannii(CRAB) is a serious threat to patient safety due to limited treatment options and propensity to spread in healthcare settings. Using Emerging Infections Program (EIP) data, we describe changes in CRAB incidence and epidemiology. Methods:During January 2012 to December 2018, 9 sites (Colorado, Connecticut, Georgia, Maryland, Minnesota, New Mexico, New York, Oregon, and Tennessee) participated in active laboratory- and population-based surveillance. An incident case was defined as the first isolation of A. baumanniicomplex, in a 30-day period, resistant to ≥1 carbapenem (excluding ertapenem) from a normally sterile site or urine of a surveillance area resident. Cases were considered hospital-onset (HO) if the culture was collected >3 days after hospital admission; all others were community-onset (CO). Cases were classified as device-associated (DA) if the patient had 1 or more medical devices (ie, urinary catheter, central venous catheter (CVC), endotracheal/nasotracheal tube, tracheostomy, or another indwelling device) present in the 2 days prior to culture collection. Temporal trends were estimated using generalized linear models adjusted for age, race, sex, and EIP site. Results:Overall, 984 incident CRAB cases were identified, representing 849 patients. Among these patients, 291 (34%) were women, 510 (61%) were nonwhite, and the median age was 62 years (mean, 59; range, 0–102). Among the cases, 226 (23%) were HO; 758 (77%) were CO; and 793 (81%) were DA. Overall incidence rates in 2012 and 2018 were 1.58 (95% CI, 1.29–1.90) and 0.60 (95% CI, 0.40–0.67) per 100,000 population, respectively. There was a 15% annual decrease in incidence (adjusted rate ratio [aRR] 0.85; 95% CI: 0.82-0.88, P< .0001). Decreases were observed among sterile site (aRR 0.88; 95% CI, 0.84–0.93) and urine cases (aRR 0.83; 95% CI, 0.80–0.87). Annual decreases occurred for HO cases (aRR, 0.78; 95% CI, 0.73–0.85) and CO cases (aRR, 0.86; 95% CI, 0.83–0.9). The DA cases decreased 16% annually overall (aRR, 0.84; 95% CI, 0.81–0.88). Decreases among cases in patients with CVC (aRR, 0.85; 95% CI, 0.80–0.90) and urinary catheters (aRR, 0.84; 95% CI, 0.80–0.88) were smaller than what was seen in patients with other indwelling devices (aRR, 0.81; 95% CI, 0.77–0.86). Discussion:Overall, from 2012 to 2018, the incidence of CRAB decreased >60%. Decreases were observed in all case groups, regardless of source, infection onset location, or types of devices. Smaller annual decreases in rates of CO-CRAB than HO-CRAB suggest that there may be opportunities to accelerate prevention outside the hospital to further reduce the incidence of these difficult-to-treat infections.Funding:NoneDisclosures:None

Published
2020
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45. Identification of Colonized Patients During an Outbreak of Candida aurisUsing a Regional Health Information Exchange

Author

Brooks, Richard, Vaeth, Elisabeth, Saunders, Heather, Blood, Tim, Grace, Brittany, Blythe, David, Klein, Liore, Reuben, Jacqueline, Trappler, Regan, Iyengar, Preetha, Blake, Emily, Lineberger, Sarah, Abdelfattah, Rehab, Tully, Kathleen, Forsberg, Kaitlin, Walters, Maroya, and Vallabhaneni, Snigdha

Abstract

Background:In June 2019, the Maryland Department of Health (MDH) was notified of a hospitalized patient with Candida aurisbloodstream infection. The MDH initiated a contact investigation to identify additional patients with C. auriscolonization. Many of the contacts had been discharged home from the hospital and were therefore not available for screening. Healthcare facilities in Maryland, Virginia, and Washington, DC, submit patient data to a regional health information exchange (HIE) called the Chesapeake Regional Information System for our Patients (CRISP). CRISP includes a notification system that alerts providers when flagged patients have healthcare encounters. We aimed to use this system to identify discharged C. auriscontacts on their next inpatient encounter to rapidly screen them and to detect new cases. Methods:C. auriscontacts were defined as patients located on an inpatient unit on the same day, receiving wound care from the same team, or having a procedure in the same operating room on the same day as the index patient or any patients subsequently identified as having C. aurisinfection or colonization detected either during the normal course of clinical care or through screening. Contacts who remained hospitalized were screened during inpatient point prevalence surveys (PPSs). Contacts discharged to postacute-care facilities were screened by facility staff. Contacts who had been discharged home were flagged in CRISP, and MDH staff received CRISP encounter alerts when these patients were readmitted. MDH staff then contacted the admitting facilities to recommend screening for C. auris. Axilla and groin swabs were collected and tested by rt-PCR at the Mid-Atlantic Regional Antibiotic Resistance Laboratory Network laboratory. Results:As of October 8, 2019, 4,017 contacts were identified. Among these, 936 (23%) contacts at 56 healthcare facilities (33 acute-care hospitals and 23 postacute-care facilities) were screened for C. auris,and 10 patients with C. auriscolonization were identified (1.1% of contacts who underwent C. aurisscreening). Of these, 6 (60%) were identified through CRISP notification and 4 (40%) were identified by PPSs conducted in acute-care hospitals. Conclusions:In this ongoing C. aurisoutbreak, a large proportion of colonized patients was identified using an electronic encounter notification system within a regional HIE. This approach was effective for identifying opportunities to screen contacts at their next healthcare encounter and can augment other means of case detection, like PPSs. HIEs should incorporate mechanisms to facilitate contact tracing for public health investigations.Funding:NoneDisclosures:None

Published
2020
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46. C. auris and neighborhood socioeconomic vulnerability in the state of Maryland from 2019 to 2022.

Author

Smith LL, Falvey J, Grace B, Vaeth E, Rubin J, Perlmutter R, Blythe D, Hawkins D, Mbuthia M, Roghmann MC, Rock C, and Leekha S

Abstract

Background: Candida auris is an emerging fungal pathogen increasingly recognized as a cause of healthcare-associated infections including outbreaks., Methods: We performed a mixed-methods study to characterize the emergence of C. auris in the state of Maryland from 2019 to 2022, with a focus on socioeconomic vulnerability and infection prevention opportunities. We describe all case-patients of C. auris among Maryland residents from June 2019 to December 2021 detected by Maryland Department of Health. We compared neighborhood socioeconomic characteristics of skilled nursing facilities (SNFs) with and without C. auris transmission outbreaks using both the social vulnerability index (SVI) and the area deprivation index (ADI). The SVI and the ADI were obtained at the state level, with an SVI ≥ 75th percentile or an ADI ≥ 80th percentile considered severely disadvantaged. We summarized infection control assessments at SNFs with outbreaks using a qualitative analysis., Results: A total of 140 individuals tested positive for C. auris in the study period in Maryland; 46 (33%) had a positive clinical culture. Sixty (43%) were associated with a SNF, 37 (26%) were ventilated, and 87 (62%) had a documented wound. Separate facility-level neighborhood analysis showed SNFs with likely C. auris transmission were disproportionately located in neighborhoods in the top quartile of deprivation by the SVI, characterized by low socioeconomic status and high proportion of racial/ethnic minorities. Multiple infection control deficiencies were noted at these SNFs., Conclusion: Neighborhood socioeconomic vulnerability may contribute to the emergence and transmission of C. auris in a community.

Published
2024
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47. Candida auris in a U.S. Patient with Carbapenemase-Producing Organisms and Recent Hospitalization in Kenya.

Author

Brooks RB, Walters M, Forsberg K, Vaeth E, Woodworth K, and Vallabhaneni S

Subjects
Humans, Kenya, United States, Bacterial Proteins biosynthesis, Candida isolation & purification, Candidiasis diagnosis, Hospitalization statistics & numerical data, beta-Lactamases biosynthesis
Abstract

Candida auris is an emerging drug-resistant yeast that causes outbreaks in health care facilities; cases have been reported from approximately 30 countries. U.S. cases of C. auris are likely the result of importation from abroad followed by extensive local transmission in health care settings (1). Early detection of Candida auris is key to preventing its spread. C. auris frequently co-occurs with carbapenemase-producing organisms (CPOs), like carbapenem-resistant Enterobacteriaceae (CRE), organisms for which testing and public health response capacity substantially increased beginning in 2017. In September 2018, the Maryland Department of Health (MDH) was notified of a hospitalized resident with CPO infection and colonization and recent hospitalization in Kenya. In light of this history, the patient was screened for C. auris and found to be colonized. Public health responses to CPOs can aid in the early identification of C. auris. As part of CPO investigations, health departments should assess whether the patient has risk factors for C. auris and ensure that patients at risk are tested promptly., Competing Interests: All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

Published
2019
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