{"id":4686,"date":"2023-09-15T13:14:11","date_gmt":"2023-09-15T17:14:11","guid":{"rendered":"https:\/\/www.vdh.virginia.gov\/haiar\/?page_id=4686"},"modified":"2025-05-19T09:57:33","modified_gmt":"2025-05-19T13:57:33","slug":"carbapenemase-producing-organisms-quarterly-report","status":"publish","type":"page","link":"https:\/\/www.vdh.virginia.gov\/haiar\/carbapenemase-producing-organisms-quarterly-report\/","title":{"rendered":"Carbapenemase-Producing Organisms Quarterly Report"},"content":{"rendered":"<p><strong>On this page<\/strong>: <a href=\"#Overview\">Overview<\/a> | <a href=\"#HPR\">Health Planning Region<\/a> | <a href=\"#CP-CRE\">Carbapenemase-producing Carbapenem-resistant Enterobacterales (CP-CRE)<\/a> | <a href=\"#CP-CRPA\">Carbapenemase-producing Carbapenem-resistant Pseudomonas aeruginosa (CP-CRPA)<\/a> | <a href=\"#CP-CRAB\">Carbapenemase-producing Carbapenem-resistant Acinetobacter baumannii (CP-CRAB)<\/a> | <a href=\"#Lab\">Laboratory Submissions<\/a> | <a href=\"#Additional\">Additional Information<\/a><\/p>\n<p>The HAI\/AR Program produces quarterly case reports to inform prevention responses to help contain the spread of these highly-resistant organisms.<\/p>\n<p>Organisms that have developed resistance to carbapenems are known as carbapenem-resistant organisms (CRO). Carbapenems are a class of broad-spectrum antibiotics reserved to treat serious multidrug-resistant infections. The CDC considers CROs an urgent threat in the United States. CROs are classified into two categories based on their ability to produce carbapenemases. Organisms that contain a carbapenemase are known as carbapenemase-producing organisms (CPOs). Carbapenemases are enzymes that break apart the carbapenem antibiotic, rendering it inactive and useless to treat infections. Carbapenemases are often located on mobile genetic elements (e.g., plasmids) enhancing wider spread and transmission to other patients.<\/p>\n<p>Carbapenemase-producing organisms (CPOs) were added to the reportable disease list and conditions reportable by directors of laboratories on November 14, 2018. For more details for data and methods used, please see additional information section.<\/p>\n<h2><a id=\"Overview\"><\/a>CPO Quarterly Report for Healthcare Providers Overview<\/h2>\n<p><span class=\"ui-provider bxp bxq bxr bxs bxt bxu bxv bxw bxx bxy bxz bya byb byc byd bye byf byg byh byi byj byk byl bym byn byo byp byq byr bys byt byu byv byw byx\" dir=\"ltr\"><strong>Directions:<\/strong> Please use the filters at the top to view the data by carbapenemase genes and specimen collection reason; multiple criteria could be selected for each category.<\/span><\/p>\n<p><div class='tableauPlaceholder' id='viz1715031717532' style='position: relative'><noscript><a href='#'><img alt='1. Overall ' src='https:&#47;&#47;public.tableau.com&#47;static&#47;images&#47;CP&#47;CPOQuarterlyReportforHealthcareProviders&#47;1_Overall&#47;1_rss.png' style='border: none' \/><\/a><\/noscript><object class='tableauViz'  style='display:none;'><param name='host_url' value='https%3A%2F%2Fpublic.tableau.com%2F' \/> <param name='embed_code_version' value='3' \/> <param name='site_root' value='' \/><param name='name' value='CPOQuarterlyReportforHealthcareProviders&#47;1_Overall' \/><param name='tabs' value='no' \/><param name='toolbar' value='yes' \/><param name='static_image' value='https:&#47;&#47;public.tableau.com&#47;static&#47;images&#47;CP&#47;CPOQuarterlyReportforHealthcareProviders&#47;1_Overall&#47;1.png' \/> <param name='animate_transition' value='yes' \/><param name='display_static_image' value='yes' \/><param name='display_spinner' value='yes' \/><param name='display_overlay' value='yes' \/><param name='display_count' value='yes' \/><param name='language' value='en-US' \/><param name='filter' value='publish=yes' \/><\/object><\/div>                <script type='text\/javascript'>                    var divElement = document.getElementById('viz1715031717532');                    var vizElement = divElement.getElementsByTagName('object')[0];                    if ( divElement.offsetWidth > 800 ) { vizElement.style.width='1000px';vizElement.style.height='1527px';} else if ( divElement.offsetWidth > 500 ) { vizElement.style.width='1000px';vizElement.style.height='1527px';} else { vizElement.style.width='100%';vizElement.style.height='1427px';}                     var scriptElement = document.createElement('script');                    scriptElement.src = 'https:\/\/public.tableau.com\/javascripts\/api\/viz_v1.js';                    vizElement.parentNode.insertBefore(scriptElement, vizElement);                <\/script><\/p>\n<hr \/>\n<h2><b><a id=\"HPR\"><\/a>Number of CPO Cases by Health Planning Region<\/b><\/h2>\n<p><b>Directions<\/b>: Please select the criteria on the right; multiple criteria could be selected for each category.<\/p>\n<p><div class='tableauPlaceholder' id='viz1715031731007' style='position: relative'><noscript><a href='#'><img alt='2. Maps ' src='https:&#47;&#47;public.tableau.com&#47;static&#47;images&#47;CP&#47;CPOQuarterlyReportforHealthcareProviders&#47;2_Maps&#47;1_rss.png' style='border: none' \/><\/a><\/noscript><object class='tableauViz'  style='display:none;'><param name='host_url' value='https%3A%2F%2Fpublic.tableau.com%2F' \/> <param name='embed_code_version' value='3' \/> <param name='site_root' value='' \/><param name='name' value='CPOQuarterlyReportforHealthcareProviders&#47;2_Maps' \/><param name='tabs' value='no' \/><param name='toolbar' value='yes' \/><param name='static_image' value='https:&#47;&#47;public.tableau.com&#47;static&#47;images&#47;CP&#47;CPOQuarterlyReportforHealthcareProviders&#47;2_Maps&#47;1.png' \/> <param name='animate_transition' value='yes' \/><param name='display_static_image' value='yes' \/><param name='display_spinner' value='yes' \/><param name='display_overlay' value='yes' \/><param name='display_count' value='yes' \/><param name='language' value='en-US' \/><\/object><\/div>                <script type='text\/javascript'>                    var divElement = document.getElementById('viz1715031731007');                    var vizElement = divElement.getElementsByTagName('object')[0];                    if ( divElement.offsetWidth > 800 ) { vizElement.style.width='1000px';vizElement.style.height='827px';} else if ( divElement.offsetWidth > 500 ) { vizElement.style.width='1000px';vizElement.style.height='827px';} else { vizElement.style.width='100%';vizElement.style.height='927px';}                     var scriptElement = document.createElement('script');                    scriptElement.src = 'https:\/\/public.tableau.com\/javascripts\/api\/viz_v1.js';                    vizElement.parentNode.insertBefore(scriptElement, vizElement);                <\/script><\/p>\n<hr \/>\n<h2><b><a id=\"CP-CRE\"><\/a>Carbapenemase-producing Carbapenem-resistant Enterobacterales<\/b><b> (CP-CRE)<\/b><\/h2>\n<p><span class=\"TextRun SCXW168642797 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW168642797 BCX8\">Bacteria from the <\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW168642797 BCX8\">Enterobacterales<\/span><span class=\"NormalTextRun SCXW168642797 BCX8\"> family, including <\/span><\/span><span class=\"TextRun SCXW168642797 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW168642797 BCX8\">Klebsiella<\/span><\/span><span class=\"TextRun SCXW168642797 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW168642797 BCX8\"> species and <\/span><\/span><span class=\"TextRun SCXW168642797 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW168642797 BCX8\">Escherichia coli<\/span><\/span><span class=\"TextRun SCXW168642797 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW168642797 BCX8\">, can produce <\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW168642797 BCX8\">carbapenemase<\/span><span class=\"NormalTextRun SCXW168642797 BCX8\">. According to the<\/span><\/span> <a class=\"Hyperlink SCXW168642797 BCX8\" href=\"https:\/\/www.cdc.gov\/drugresistance\/ar-lab-networks\/domestic.html\" target=\"_blank\" rel=\"noreferrer noopener\"><span class=\"TextRun Underlined SCXW168642797 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW168642797 BCX8\" data-ccp-charstyle=\"Hyperlink\">CDC\u2019s AR Lab Network<\/span><\/span><\/a><span class=\"TextRun SCXW168642797 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW168642797 BCX8\">, about 40% of carbapenem-resistant <\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW168642797 BCX8\">Enterobacterales<\/span><span class=\"NormalTextRun SCXW168642797 BCX8\"> (CRE) isolates from the Mid-Atlantic region produced one of the five targeted <\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW168642797 BCX8\">carbapenemase<\/span><span class=\"NormalTextRun SCXW168642797 BCX8\"> genes. In addition to <\/span><span class=\"NormalTextRun SCXW168642797 BCX8\">CP-<\/span><span class=\"NormalTextRun SCXW168642797 BCX8\">C<\/span><span class=\"NormalTextRun SCXW168642797 BCX8\">R<\/span><span class=\"NormalTextRun SCXW168642797 BCX8\">Es being reportable, laboratories are also <\/span><span class=\"NormalTextRun SCXW168642797 BCX8\">required<\/span><span class=\"NormalTextRun SCXW168642797 BCX8\"> to <\/span><span class=\"NormalTextRun SCXW168642797 BCX8\">forward<\/span><span class=\"NormalTextRun SCXW168642797 BCX8\"> CRE isolates to the state public health lab where <\/span><span class=\"NormalTextRun SCXW168642797 BCX8\">additional<\/span><span class=\"NormalTextRun SCXW168642797 BCX8\"> testing is performed to <\/span><span class=\"NormalTextRun SCXW168642797 BCX8\">determine<\/span><span class=\"NormalTextRun SCXW168642797 BCX8\"> the presence of a <\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW168642797 BCX8\">carbapenemase<\/span><span class=\"NormalTextRun SCXW168642797 BCX8\"> and the specific gene target.<\/span><\/span><span class=\"EOP SCXW168642797 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<p><div class='tableauPlaceholder' id='viz1715031764073' style='position: relative'><noscript><a href='#'><img alt='3. Enterobacterales ' src='https:&#47;&#47;public.tableau.com&#47;static&#47;images&#47;CP&#47;CPOQuarterlyReportforHealthcareProviders&#47;3_Enterobacterales&#47;1_rss.png' style='border: none' \/><\/a><\/noscript><object class='tableauViz'  style='display:none;'><param name='host_url' value='https%3A%2F%2Fpublic.tableau.com%2F' \/> <param name='embed_code_version' value='3' \/> <param name='site_root' value='' \/><param name='name' value='CPOQuarterlyReportforHealthcareProviders&#47;3_Enterobacterales' \/><param name='tabs' value='no' \/><param name='toolbar' value='yes' \/><param name='static_image' value='https:&#47;&#47;public.tableau.com&#47;static&#47;images&#47;CP&#47;CPOQuarterlyReportforHealthcareProviders&#47;3_Enterobacterales&#47;1.png' \/> <param name='animate_transition' value='yes' \/><param name='display_static_image' value='yes' \/><param name='display_spinner' value='yes' \/><param name='display_overlay' value='yes' \/><param name='display_count' value='yes' \/><param name='language' value='en-US' \/><\/object><\/div>                <script type='text\/javascript'>                    var divElement = document.getElementById('viz1715031764073');                    var vizElement = divElement.getElementsByTagName('object')[0];                    if ( divElement.offsetWidth > 800 ) { vizElement.style.width='1000px';vizElement.style.height='1027px';} else if ( divElement.offsetWidth > 500 ) { vizElement.style.width='1000px';vizElement.style.height='1027px';} else { vizElement.style.width='100%';vizElement.style.height='1677px';}                     var scriptElement = document.createElement('script');                    scriptElement.src = 'https:\/\/public.tableau.com\/javascripts\/api\/viz_v1.js';                    vizElement.parentNode.insertBefore(scriptElement, vizElement);                <\/script><\/p>\n<hr \/>\n<h2><b><a id=\"CP-CRPA\"><\/a>Carbapenemase-producing Carbapenem-resistant <\/b><b><i>Pseudomonas aeruginosa<\/i><\/b><b> (CP-CRPA)<\/b><\/h2>\n<p><span class=\"TextRun SCXW205392955 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW205392955 BCX8\">According to the <\/span><\/span><a class=\"Hyperlink SCXW205392955 BCX8\" href=\"https:\/\/www.cdc.gov\/drugresistance\/ar-lab-networks\/domestic.html\" target=\"_blank\" rel=\"noreferrer noopener\"><span class=\"TextRun Underlined SCXW205392955 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW205392955 BCX8\" data-ccp-charstyle=\"Hyperlink\">CDC\u2019s AR Lab Network<\/span><\/span><\/a><span class=\"TextRun SCXW205392955 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW205392955 BCX8\">, less than 2% of carbapenem-resistant <\/span><\/span><span class=\"TextRun SCXW205392955 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW205392955 BCX8\">Pseudomonas aeruginosa<\/span><\/span><span class=\"TextRun SCXW205392955 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW205392955 BCX8\"> (CRPA) isolates from the Mid-Atlantic region produced one of the five targeted <\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW205392955 BCX8\">carbapenemase<\/span><span class=\"NormalTextRun SCXW205392955 BCX8\"> genes. In addition to CP-CRPAs being reportable, laboratories are also <\/span><span class=\"NormalTextRun SCXW205392955 BCX8\">required<\/span><span class=\"NormalTextRun SCXW205392955 BCX8\"> to <\/span><span class=\"NormalTextRun SCXW205392955 BCX8\">forward<\/span> <span class=\"NormalTextRun SCXW205392955 BCX8\">CRPA isolates to the state public health lab where <\/span><span class=\"NormalTextRun SCXW205392955 BCX8\">additional<\/span><span class=\"NormalTextRun SCXW205392955 BCX8\"> testing is performed to <\/span><span class=\"NormalTextRun SCXW205392955 BCX8\">determine<\/span><span class=\"NormalTextRun SCXW205392955 BCX8\"> the presence of a <\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW205392955 BCX8\">carbapenemase<\/span><span class=\"NormalTextRun SCXW205392955 BCX8\"> and the specific gene target.<\/span><\/span><span class=\"EOP SCXW205392955 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<p><div class='tableauPlaceholder' id='viz1715031795173' style='position: relative'><noscript><a href='#'><img alt='4. Pseudomonas aeruginosa ' src='https:&#47;&#47;public.tableau.com&#47;static&#47;images&#47;CP&#47;CPOQuarterlyReportforHealthcareProviders&#47;4_Pseudomonasaeruginosa&#47;1_rss.png' style='border: none' \/><\/a><\/noscript><object class='tableauViz'  style='display:none;'><param name='host_url' value='https%3A%2F%2Fpublic.tableau.com%2F' \/> <param name='embed_code_version' value='3' \/> <param name='site_root' value='' \/><param name='name' value='CPOQuarterlyReportforHealthcareProviders&#47;4_Pseudomonasaeruginosa' \/><param name='tabs' value='no' \/><param name='toolbar' value='yes' \/><param name='static_image' value='https:&#47;&#47;public.tableau.com&#47;static&#47;images&#47;CP&#47;CPOQuarterlyReportforHealthcareProviders&#47;4_Pseudomonasaeruginosa&#47;1.png' \/> <param name='animate_transition' value='yes' \/><param name='display_static_image' value='yes' \/><param name='display_spinner' value='yes' \/><param name='display_overlay' value='yes' \/><param name='display_count' value='yes' \/><param name='language' value='en-US' \/><\/object><\/div>                <script type='text\/javascript'>                    var divElement = document.getElementById('viz1715031795173');                    var vizElement = divElement.getElementsByTagName('object')[0];                    if ( divElement.offsetWidth > 800 ) { vizElement.style.width='1000px';vizElement.style.height='927px';} else if ( divElement.offsetWidth > 500 ) { vizElement.style.width='1000px';vizElement.style.height='927px';} else { vizElement.style.width='100%';vizElement.style.height='1427px';}                     var scriptElement = document.createElement('script');                    scriptElement.src = 'https:\/\/public.tableau.com\/javascripts\/api\/viz_v1.js';                    vizElement.parentNode.insertBefore(scriptElement, vizElement);                <\/script><\/p>\n<hr \/>\n<h2><b><a id=\"CP-CRAB\"><\/a>Carbapenemase-producing Carbapenem-resistant <\/b><b><i>Acinetobacter baumannii<\/i><\/b><b> (CP-CRAB)<\/b><\/h2>\n<p><span class=\"TextRun SCXW220265085 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW220265085 BCX8\">Testing in the <\/span><\/span><a class=\"Hyperlink SCXW220265085 BCX8\" href=\"https:\/\/www.cdc.gov\/drugresistance\/ar-lab-networks\/domestic.html\" target=\"_blank\" rel=\"noreferrer noopener\"><span class=\"TextRun Underlined SCXW220265085 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW220265085 BCX8\" data-ccp-charstyle=\"Hyperlink\">CDC\u2019s AR Lab Network<\/span><\/span><\/a><span class=\"TextRun SCXW220265085 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW220265085 BCX8\"> during 2019 found that <\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW220265085 BCX8\">carbapenemase<\/span><span class=\"NormalTextRun SCXW220265085 BCX8\"> genes were detected in 83% of Carbapenem-resistant <\/span><\/span><em><span class=\"TextRun SCXW220265085 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW220265085 BCX8\">Acinetobacter baumannii<\/span><\/span><\/em><span class=\"TextRun SCXW220265085 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW220265085 BCX8\"> (CRAB) isolates tested. In Virginia, CP<\/span><span class=\"NormalTextRun SCXW220265085 BCX8\">-CRAB<\/span><span class=\"NormalTextRun SCXW220265085 BCX8\"> is reportable, however laboratories are not <\/span><span class=\"NormalTextRun SCXW220265085 BCX8\">required<\/span><span class=\"NormalTextRun SCXW220265085 BCX8\"> to <\/span><span class=\"NormalTextRun SCXW220265085 BCX8\">forward<\/span><span class=\"NormalTextRun SCXW220265085 BCX8\"> CRAB isolates. Some laboratories voluntarily <\/span><span class=\"NormalTextRun SCXW220265085 BCX8\">submit<\/span><span class=\"NormalTextRun SCXW220265085 BCX8\"> CRAB isolates to the public health laboratory for <\/span><span class=\"NormalTextRun SCXW220265085 BCX8\">additional<\/span><span class=\"NormalTextRun SCXW220265085 BCX8\"> testing.<\/span><\/span><span class=\"TextRun SCXW220265085 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"auto\"><span class=\"NormalTextRun SCXW220265085 BCX8\"> Starting in 2023, DCLS implemented an expanded panel for CRAB <\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW220265085 BCX8\">carbapenemase<\/span><span class=\"NormalTextRun SCXW220265085 BCX8\">\u00a0testing. See <\/span><span class=\"NormalTextRun SCXW220265085 BCX8\">additional<\/span><span class=\"NormalTextRun SCXW220265085 BCX8\"> information section for laboratory testing details.<\/span><\/span><span class=\"TextRun SCXW220265085 BCX8\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW220265085 BCX8\"> Data below are from select laboratories in Virginia and the data should be interpreted with caution as they may not be representative of every Virginia region.<\/span><\/span><span class=\"EOP SCXW220265085 BCX8\" data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:259}\">\u00a0<\/span><\/p>\n<p><div class='tableauPlaceholder' id='viz1715031837932' style='position: relative'><noscript><a href='#'><img alt='5. Acinetobacter baumannii ' src='https:&#47;&#47;public.tableau.com&#47;static&#47;images&#47;CP&#47;CPOQuarterlyReportforHealthcareProviders&#47;5_Acinetobacterbaumannii&#47;1_rss.png' style='border: none' \/><\/a><\/noscript><object class='tableauViz'  style='display:none;'><param name='host_url' value='https%3A%2F%2Fpublic.tableau.com%2F' \/> <param name='embed_code_version' value='3' \/> <param name='site_root' value='' \/><param name='name' value='CPOQuarterlyReportforHealthcareProviders&#47;5_Acinetobacterbaumannii' \/><param name='tabs' value='no' \/><param name='toolbar' value='yes' \/><param name='static_image' value='https:&#47;&#47;public.tableau.com&#47;static&#47;images&#47;CP&#47;CPOQuarterlyReportforHealthcareProviders&#47;5_Acinetobacterbaumannii&#47;1.png' \/> <param name='animate_transition' value='yes' \/><param name='display_static_image' value='yes' \/><param name='display_spinner' value='yes' \/><param name='display_overlay' value='yes' \/><param name='display_count' value='yes' \/><param name='language' value='en-US' \/><\/object><\/div>                <script type='text\/javascript'>                    var divElement = document.getElementById('viz1715031837932');                    var vizElement = divElement.getElementsByTagName('object')[0];                    if ( divElement.offsetWidth > 800 ) { vizElement.style.width='1000px';vizElement.style.height='927px';} else if ( divElement.offsetWidth > 500 ) { vizElement.style.width='1000px';vizElement.style.height='927px';} else { vizElement.style.width='100%';vizElement.style.height='1727px';}                     var scriptElement = document.createElement('script');                    scriptElement.src = 'https:\/\/public.tableau.com\/javascripts\/api\/viz_v1.js';                    vizElement.parentNode.insertBefore(scriptElement, vizElement);                <\/script><\/p>\n<hr \/>\n<h2><b><a id=\"Lab\"><\/a>Laboratory Submissions<\/b><\/h2>\n<p>Lab submission data are included to aid in the interpretation of case counts. Number of screening specimens submitted for testing varies by region. Number of clinical specimens submitted varies by organism.<\/p>\n<p><div class='tableauPlaceholder' id='viz1715031873741' style='position: relative'><noscript><a href='#'><img alt='6. Lab Submissions ' src='https:&#47;&#47;public.tableau.com&#47;static&#47;images&#47;CP&#47;CPOQuarterlyReportforHealthcareProviders&#47;6_LabSubmissions&#47;1_rss.png' style='border: none' \/><\/a><\/noscript><object class='tableauViz'  style='display:none;'><param name='host_url' value='https%3A%2F%2Fpublic.tableau.com%2F' \/> <param name='embed_code_version' value='3' \/> <param name='site_root' value='' \/><param name='name' value='CPOQuarterlyReportforHealthcareProviders&#47;6_LabSubmissions' \/><param name='tabs' value='no' \/><param name='toolbar' value='yes' \/><param name='static_image' value='https:&#47;&#47;public.tableau.com&#47;static&#47;images&#47;CP&#47;CPOQuarterlyReportforHealthcareProviders&#47;6_LabSubmissions&#47;1.png' \/> <param name='animate_transition' value='yes' \/><param name='display_static_image' value='yes' \/><param name='display_spinner' value='yes' \/><param name='display_overlay' value='yes' \/><param name='display_count' value='yes' \/><param name='language' value='en-US' \/><\/object><\/div>                <script type='text\/javascript'>                    var divElement = document.getElementById('viz1715031873741');                    var vizElement = divElement.getElementsByTagName('object')[0];                    if ( divElement.offsetWidth > 800 ) { vizElement.style.width='1000px';vizElement.style.height='827px';} else if ( divElement.offsetWidth > 500 ) { vizElement.style.width='1000px';vizElement.style.height='827px';} else { vizElement.style.width='100%';vizElement.style.height='1177px';}                     var scriptElement = document.createElement('script');                    scriptElement.src = 'https:\/\/public.tableau.com\/javascripts\/api\/viz_v1.js';                    vizElement.parentNode.insertBefore(scriptElement, vizElement);                <\/script><\/p>\n<hr \/>\n<h2><b><a id=\"Additional\"><\/a>Additional Information<\/b><\/h2>\n<ol>\n<li><strong>How is a CPO case determined?<\/strong>\n<ol style=\"list-style-type: lower-alpha;\">\n<li>Cases are determined using the <a href=\"https:\/\/ndc.services.cdc.gov\/case-definitions\/carbapenemase-producing-organisms-cpo\/\">CSTE Case Definition<\/a> for CPOs. The CSTE case definitions were revised in January 2023. Cases counted prior to January 2023 were classified using the 2019 CSTE Case Definition.<\/li>\n<\/ol>\n<\/li>\n<li><strong>Where do the data come from?<\/strong>\n<ol style=\"list-style-type: lower-alpha;\">\n<li>Healthcare facilities and\/or clinical laboratories are required to report CPO cases to their local health department. Local epidemiologists determine case status and respond to cases by collecting data, providing infection prevention recommendations, and conducting a contact investigation. Laboratory and case information are entered in the Virginia Electronic Disease Surveillance System (VEDSS). The VDH Antimicrobial Resistance Epidemiologist queries VEDSS to develop these reports. Cases are assigned to a month based on the date the investigation was started at the local health department. Cases are assigned to a region of the state based on the patient&#8217;s home address.<\/li>\n<\/ol>\n<\/li>\n<li><strong>How are laboratory data submitted?<\/strong>\n<ol style=\"list-style-type: lower-alpha;\">\n<li>Virginia requires clinical laboratories to forward CRE and CRPA isolates to DCLS for additional testing to determine the presence of a carbapenemase. Clinical laboratories can also voluntarily send CRAB isolates for additional testing. Because CRAB isolate submission is voluntary, caution should be used when interpreting overall burden of carbapenemase-producing <em>Acinetobacter baumannii<\/em> in Virginia.<\/li>\n<\/ol>\n<\/li>\n<li><strong>What is the difference between screening and clinical cases?<\/strong>\n<ol style=\"list-style-type: lower-alpha;\">\n<li>Screening cases are typically discovered during a screening process, such as admission screenings or if the patient was screened because of their contact with a known case. Specimens collected for screening are rectal swabs and are tested at the Mid-Atlantic Antimicrobial Resistant Laboratory Network. Screening specimens are only tested for the carbapenemase genes. Routine testing of screening specimens does not include organism identification, which is why the organism-specific tabs in this report do not include screening cases.<\/li>\n<li>Clinical cases can come from a variety of specimen sources (e.g., wound, urine, blood). These specimens may be submitted through our state public health lab (DCLS) or from other clinical laboratories.<\/li>\n<\/ol>\n<\/li>\n<li><strong>What testing is performed by the public health labs?<\/strong>\n<ol style=\"list-style-type: upper-alpha;\">\n<li>Clinical specimens are forwarded to the Virginia Division for Consolidated Laboratory Services (DCLS) for additional testing. Testing varies by organism.\n<ol style=\"list-style-type: lower-alpha;\">\n<li>Carbapenem-resistant Enterobacterales and carbapenem-resistant <em>Pseudomonas aeruginosa<\/em> testing is as follows:\n<ol style=\"list-style-type: lower-roman;\">\n<li>Phenotypic confirmation of carbapenemase production (mCIM)\u200b<\/li>\n<li>Molecular detection of resistance mechanisms by real-time PCR for mCIM positive isolates for the following targets (KPC, NDM, OXA-48, VIM, IMP)<\/li>\n<\/ol>\n<\/li>\n<li>Carbapenem-resistant <em>Acinetobacter baumannii<\/em> testing is as follows:\n<ol style=\"list-style-type: lower-roman;\">\n<li>Molecular detection of resistance mechanisms by real-time PCR on all isolates for the following targets (IMP, KPC, NDM, OXA-23, OXA-24\/40, OXA-48, OXA-58, OXA-235, and VIM)<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<\/li>\n<li>Screening specimens are tested at the CDC\u2019s Mid-Atlantic ARLN located in Maryland.<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>On this page: Overview | Health Planning Region | Carbapenemase-producing Carbapenem-resistant Enterobacterales (CP-CRE) | Carbapenemase-producing Carbapenem-resistant Pseudomonas aeruginosa (CP-CRPA) | Carbapenemase-producing Carbapenem-resistant Acinetobacter baumannii (CP-CRAB) | Laboratory Submissions | Additional [&hellip;]<\/p>\n","protected":false},"author":452,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_lmt_disableupdate":"no","_lmt_disable":"","footnotes":""},"tags":[],"class_list":["post-4686","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - 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