title: Lessons learned from initial reporting of carbapenem-resistant Enterobacteriaceae in New York State hospitals, 2013-2014.
abstract: BACKGROUND
  Carbapenem-resistant Enterobacteriaceae (CRE) are an urgent concern in health care in the United States because of high attributable mortality and versatile resistance mechanisms. CRE reporting was mandated in New York State (NYS) hospitals in July 2013.
  
  
  METHODS
  Infection preventionists from the NYS Department of Health audited hospital-reported CRE data by comparing laboratory records with cases reported to the National Healthcare Safety Network (NHSN). Information regarding microbiology laboratory testing methodologies was obtained through a survey in October 2013.
  
  
  RESULTS
  There were 1,151 CRE laboratory reports audited, with 13.6% determined not to have been reported to the NHSN when they should have been and 4.6% determined to be reported in error. There were a variety of errors, including lapses in surveillance and misinterpretation of the surveillance definition.
  
  
  CONCLUSIONS
  Educational initiatives that include microbiology laboratory staff, improvements in the use of laboratory information systems to communicate with infection prevention, and updated NHSN definitions should improve the accuracy and consistency of CRE reporting in NYS.
authors.affiliation: Bureau of Healthcare-Associated Infections, New York State Department of Health, Albany, NY; School of Public Health, State University of New York at Albany, Albany, NY.
authors.forename: Christen L
authors.initials: CL
authors.lastname: Mayer
authors.affiliation: Bureau of Healthcare-Associated Infections, New York State Department of Health, Albany, NY; School of Public Health, State University of New York at Albany, Albany, NY. Electronic address: Valerie.haley@health.ny.gov.
authors.forename: Valerie B
authors.initials: VB
authors.lastname: Haley
authors.affiliation: Bureau of Healthcare-Associated Infections, New York State Department of Health, Albany, NY.
authors.forename: Rosalie
authors.initials: R
authors.lastname: Giardina
authors.affiliation: Bureau of Healthcare-Associated Infections, New York State Department of Health, Albany, NY.
authors.forename: Peggy A
authors.initials: PA
authors.lastname: Hazamy
authors.affiliation: Bureau of Healthcare-Associated Infections, New York State Department of Health, Albany, NY.
authors.forename: Marie
authors.initials: M
authors.lastname: Tsivitis
authors.affiliation: Bureau of Healthcare-Associated Infections, New York State Department of Health, Albany, NY.
authors.forename: Robin
authors.initials: R
authors.lastname: Knab
authors.affiliation: Bureau of Healthcare-Associated Infections, New York State Department of Health, Albany, NY; School of Public Health, State University of New York at Albany, Albany, NY.
authors.forename: Emily
authors.initials: E
authors.lastname: Lutterloh
mesh_terms: D015780:Carbapenems / Q000494:pharmacology; D003428:Cross Infection / Q000517:prevention & control*; D003625:Data Collection; D018563:Disease Notification; D004755:Enterobacteriaceae / Q000187:drug effects / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D062665:Epidemiological Monitoring; D006282:Health Personnel / Q000193:education*; D006783:Hospitals, State; D006801:Humans; D015994:Incidence; D008485:Medical Audit; D009313:National Health Programs; D009518:New York / Q000453:epidemiology; D062486:Public Health Surveillance; D018440:beta-Lactam Resistance
chemical_list: D015780:Carbapenems
keywords: Carbapenem-resistant Enterobacteriaceae; Data validation; Hospital-acquired infection; National Healthcare Safety Network