title: Impact of Delays between Clinical and Laboratory Standards Institute and Food and Drug Administration Revisions of Interpretive Criteria for Carbapenem-Resistant Enterobacteriaceae.
abstract: Delays often occur between CLSI and FDA revisions of antimicrobial interpretive criteria. Using our Regional Healthcare Ecosystem Analyst (RHEA) simulation model, we found that the 32-month delay in changing carbapenem-resistant Enterobacteriaceae (CRE) breakpoints might have resulted in 1,821 additional carriers in Orange County, CA, an outcome that could have been avoided by identifying CRE and initiating contact precautions. Policy makers should aim to minimize the delay in the adoption of new breakpoints for antimicrobials against emerging pathogens when containment of spread is paramount; delays of <1.5 years are ideal.
authors: Public Health Computational and Operations Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors: Sarah M
authors: SM
authors: Bartsch
authors: Division of Infectious Diseases and Health Policy Research Institute, University of California-Irvine School of Medicine, Orange, California, USA.
authors: Susan S
authors: SS
authors: Huang
authors: Center for Simulation and Modeling, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors: Kim F
authors: KF
authors: Wong
authors: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors: Rachel B
authors: RB
authors: Slayton
authors: Infectious Disease Clinical Outcomes Research Unit (ID-CORE), Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, California, USA.|Torrance Memorial Medical Center, Torrance, California, USA.
authors: James A
authors: JA
authors: McKinnell
authors: International Health Management Associates, Inc., Schaumburg, Illinois, USA.
authors: Daniel F
authors: DF
authors: Sahm
authors: International Health Management Associates, Inc., Schaumburg, Illinois, USA.
authors: Krystyna
authors: K
authors: Kazmierczak
authors: Public Health Computational and Operations Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors: Leslie E
authors: LE
authors: Mueller
authors: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors: John A
authors: JA
authors: Jernigan
authors: Public Health Computational and Operations Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA brucelee@jhu.edu.
authors: Bruce Y
authors: BY
authors: Lee
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015780:Carbapenems / Q000494:pharmacology*; D002353:Carrier State / Q000175:diagnosis* / Q000382:microbiology; D064790:Clinical Laboratory Services / Q000592:standards; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000175:diagnosis* / Q000382:microbiology; D006801:Humans; D017053:Infection Control / Q000379:methods; D008826:Microbial Sensitivity Tests / Q000379:methods* / Q000592:standards*; D013995:Time; D014481:United States; D037041:United States Government Agencies; D018440:beta-Lactam Resistance
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems