What Can Be Done

The Federal Government is:

• Monitoring resistance and sounding the alarm when threats emerge. CDC develops and provides new lab tests so health departments can quickly identify new threats.
• Improving identification through CDC’s AR Lab Network in all 50 states, 5 large cities, and Puerto Rico, including seven regional labs and a national tuberculosis lab for specialty testing.
• Supporting prevention experts and AR programs in every state, and providing data and recommendations for local prevention and response.
• Testing innovative infection control and prevention strategies with health care and academic partners.
• CDC funds innovative research to support Safe healthcare.

State and Local Health Departments and Labs can:

• Engage and coordinate with clinical labs and health care facilities to submit isolates (pure samples of a germ) of interest to the AR Lab Network Develop a plan to respond rapidly to unusual genes and germs when they first appear.
• Work with the AR Lab Network regional lab to monitor for, report, and coordinate investigations when unusual AR is detected in a health care facility. Investigations should include infection control assessments and colonization screening to assess for spread of the AR pathogen.
• Engage health care facilities, especially those at higher risk for transmission of MDROs, in AR prevention strategies.
• Provide education and information to healthcare facilities about antimicrobial resistant organisms, local epidemiology, and measures to prevent the spread of AR pathogens.
• Assess the quality and consistency of infection control in health care facilities across the state, especially in facilities with high-risk patients and long stays. Help improve practices.
• Provide healthcare facilities with timely lab results, recommendations, and status updates on discharges and transfers of patients with known resistance to help maintain infection prevention and control.

Health Care Facilities can:

• Plan for unusual resistance arriving at your facility. Find resources: Interim Guidance for a Public Health Response to Contain Novel or Targeted Multidrug-resistant Organisms (MDROs), New Carbapenem-Resistant Enterobacteriaceae Warrant Additional Action by Healthcare Providers
• Leadership: Work with health department to stop spread of unusual resistance. Review and support infection control in the facility.
• Clinical Labs: Know what isolates to send for testing. Establish protocols that immediately notify health department, health care provider, and infection control staff of unusual resistance. Validate new tests to detect the latest threats. If needed, use isolates from AR Isolate Bank.
• Healthcare providers, epidemiologists, and infection control staff:
  • Place Proactively identify patients at higher risk for infection or colonization with AR organisms.
    • When individuals are transferred from facilities at higher risk of MDRO transmission to acute care hospitals, consider empiric Contact Precautions or admission screening.
    • Ask patients about recent hospitalization or medical procedures outside of the U.S. during admission to a healthcare facility. Screen patients with this exposure or history for presence of unusual resistance (carbapenemase-producing organisms and Candida auris).
  • Place patients with a novel or targeted MDRO on setting-appropriate transmission-based precautions (e.g., Contact Precautions in Acute Care and Enhanced Barrier Precautions in skilled nursing facilities), assess and enhance infection control, and work with health department to screen others.
  • Communicate patient MDRO status at all transitions of care. (Inter-Facility Infection Control Transfer Form [PDF -3 pages]
  • Continue infection control assessments and colonization screenings until spread is controlled.

Everyone can:

• Inform your health care provider if you recently received health care in another country or facility.
• Talk to your health care provider about preventing infections, taking good care of chronic conditions and getting recommended vaccines.
• Practice good hygiene, such as keeping hands clean with handwashing or alcohol-based hand rubs, and keep cuts clean until healed.