04/04/2018: Lab Update: CDC’s Containment Strategy for Antibiotic-Resistant Threats: April Vital Signs

Audience: Federal government agencies, state and local health department and labs, and health care facilities

Subject: CDC’s Containment Strategy for Antibiotic-Resistant Threats: April Vital Signs

Dear LOCS members,

CDC’s most recent Vital Signs report highlights the importance of rapid identification of new or rare resistance. This is the critical first step in CDC’s Containment Strategy to stop the spread of antibiotic resistance (AR). Once AR spreads, it is harder to control. Finding and responding to unusual resistance early, before it becomes common, can help stop its spread and protect people.

The report calls on public health and health care facility experts nationwide to launch early, aggressive action—at the first sign of unusual resistance, every time. CDC highlights specific actions to take to support laboratories across the nation.

Federal Government

• 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 new AR Lab Network in all 50 states, 5 large cities, and Puerto Rico, including 7 regional labs and a national tuberculosis lab for specialty testing.
• Supporting prevention experts and 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.

State and Local Health Departments and Labs

• Make sure all health care facilities know what state and local lab support is available and what isolates (pure samples of a germ) to send for testing. Develop a plan to respond rapidly to unusual genes and germs when they first appear.
• 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.
• Coordinate with affected health care facilities, the new AR Lab Network regional lab, and CDC for every case of unusual resistance. Investigations should include onsite infection control assessments to find spread. Consider colonization screenings. Continue until spread is controlled.
• Provide timely lab results and recommendations to affected health care facilities and providers. If the patient came from or was transferred to another facility, alert that facility.
• Find resources: cdc.gov/hai/outbreaks/mdro

Health Care Facilities and Clinical Labs

• Plan for unusual resistance arriving in your facility.
• Work with the health department to stop spread of unusual resistance. Review and support infection control in the facility.
• Know what isolates to send for testing. Establish protocols that immediately notify the health department, health care provider, and infection control staff of unusual resistance. Validate new tests to identify the latest threats. If needed, use isolates from cdc.gov/arisolatebank/.
• Place patients with unusual resistance on contact precautions, assess and enhance infection control, and work with the health department to screen others. Communicate about status when patients are transferred. Continue infection control assessments and colonization screenings until spread is controlled. Ask about any recent travel or health care to identify at-risk patients.

We encourage your organization to share the CDC Vital Signs information broadly with your colleagues and partners. Visit the Vital Signs Web page to find the MMWR article, fact sheet, and other materials. CDC’s Public Health Media Library at www.cdc.gov/syndication and search on the term Vital Signs. We also invite you to join us for the Vital Signs Town Hall Teleconference on April 10, 2018, at 2 p.m. ET.

Sincerely,

Laboratory Outreach Communication System