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Technical Information - Multi-Site Gram-Negative Bacilli Surveillance Initiative (MuGSI)


The Multi-Site Gram-Negative Bacilli Surveillance Initiative or MuGSI is a part of the CDC’s Emerging Infections Program (EIP) Healthcare-Associated Infections Community Interface (HAIC) activity.  Through MuGSI, CDC is conducting active population- and laboratory-based surveillance in a defined surveillance catchment for six carbapenem-resistant organisms which include Escherichia coli, Enterobacter cloacae, Enterobacter aerogenes, Klebsiella pneumoniae, Klebsiella oxytoca, and Acinetobacter baumannii

Surveillance Objectives

  • To evaluate the population-based incidence of carbapenem-nonsusceptibility among five common strains of Enterobacteriaceae and Acinetobacter baumannii, and describe how the incidence changes over time
  • To better characterize carbapenem-nonsusceptible strains in sites submitting data in order to inform prevention efforts
  • To describe known resistance mechanisms among a subset of carbapenem-nonsusceptible Enterobacteriaceae



  • Surveillance Population
    Surveillance for these MuGSI organisms is conducted in five EIP site.  The table below illustrates the population under surveillance for each EIP site as of January 2014.
MuGSI Surveillance Population
State Population
CO 2,532,982
(5 county Denver area)
GA 3,821,534
(8 County Atlanta area)
MD 1,905,444
(3 county Baltimore area and Baltimore City)
MN 1,704,728
(2 metro Twin Cities counties)
NM 673,460
(1 county Albuquerque metro area)
NY 747,813
(1 county Rochester metro area)
OR 1,690,785
(3 county Portland area)
TN 648,295
(1 county Nashville metro area)
Total 13,725,041

Populations were obtained from the U.S. Census web site 11/8/2013 (



  1. Centers for Disease Control and Prevention (CDC).  Vital signs: Carbapenem-Resistant Enterobacteriaceae. MMWR Morb Moral Wkly Rep. 2013 Mar 5;62(9):1-6.
  2. J Reno, C Schenck, J Scott, LA Clark, W Wang, S Ray, P Vagnone JT Jacobs.  Querying Automated Antibiotic Susceptibility Testing Instruments: A Novel Population-Based Active Surveillance Method for Multidrug Resistant Gram Negative Bacilli.  Infection Control and Hospital Epidemiology. April 2014;35(4).
  3. K Shaw, JE Harper, PM Vagnone, R Lynfield. Establishing Surveillance for Carbapenem-resistant Enterobacteriaceae in Minnesota, 2012.  Infection Control and Hospital Epidemiology .April 2014;35(4).
  4. Edwin C. Pereira, MD, Kristin M. Shaw, MPH, CIC, Paula M. Snippes Vagnone, MT (ASCP), Jane E. Harper, BSN, MS, CIC, Alexander J. Kallen, MD, MPH, Brandi M. Limbago, PhD, and Ruth Lynfield, MD.  Thirty-day laboratory-based surveillance for carbapenem-resistant Enterobacteriaceae in the Minneapolis-St. Paul metropolitan area. Infection Control and Hospital Epidemiology April 2014;35(4).
  5. Pfeiffer, C., D., Cunningham, M. C., Poissant, T., Furuno, J., P., Townes, J., M., Leitz, A., Thomas, A., Buser, G., L., Arao, R., F., Beldavs, Z. G.  Establishment of a Statewide Network for Carbapenem-Resistant Enterobacteriacae Prevention in a Low-Incidence Region. Infection Control and Hospital Epidemiology. April 2014;35(4).


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