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CSTE AR/ELR Workgroup

Brooke Beaulieu, Surveillance/Informatics Program Analyst at CSTEMarion Kainer, TNElizabeth Mothershed, CDCBecky Lampkins, Manager, Surveillance/Informatics Program at CSTEElisabeth Vaeth, MDNicole Hearon, INErin Epson, CASam Horwich-Scholefield, CAMeghan Maloney, CTValerie Haley, NYErica Runningdeer, ILAlex Kallen, CDCCorinne Davis, ELR Specialist at TNScott Troppy, Surveillance Epidemiologist at MA DPHMeredith Lichtenstein, CSTE +47 others
Posted by Monica Huang ·

CRE ELR Pain Points

Please post your jurisdiction's CRE-related ELR pain points here!

Comments & Events

Scott Troppy, Surveillance Epidemiologist at MA DPH Scott Troppy, Surveillance Epidemiologist at MA DPH
Massachusetts CRE ELR Pain Points
  • Missing carbapenemase results 
  •  Unclear if carbapenemase test was actually performed (“Demonstrates production of a carbapenemase” but no evidence of that)
  • Missing MIC values (we are only getting interpretations of S, I, or R)
  • The parent/child linking of organism/susceptibility labs could be a problem, but we don’t actually know without a paper copy of the labs
  • Reported as a CRE but there are no carbapenem susceptibilities mapped
Notified 1 person
DJ Shannon, Multidrug-Resistant Organism Epidemiologist DJ Shannon, Multidrug-Resistant Organism Epidemiologist
Indiana CRE ELR Pain Points
  • Comments are sent in multiple result (OBX) segments (OBX|7 “identification and susceptibility” OBX|8 “Testing to follow.”)
  • Generic LOINC codes being used, making it difficult for our system to classify results correctly (Our system classifies at the result level)
  • No utilization of parent/child linking of susceptibility labs to the organism(s)
  • In the example discussed on the conference call, there were 3 organisms identified; and two susceptibility requested tests and results sent. It’s not easy to identify which susceptibility goes with which organism.
  • Missing MIC values and only sending the categorical results
  • Categorical results sent in the result section and quantitative sent in a note (NTE) segment
Notified 34 people
Amy Drake, NM Amy Drake
From LabCorp: Reporting of MIC values can be rejected by provider's systems.  This may require communication with vendors.
Notified 36 people
Nancy Barrett, Epi 4/PH Informatics Specialist Nancy Barrett, Epi 4/PH Informatics Specialist
Our CT PHL is starting to institute testing for CRE using Phenotype testing, Kirby-Bauer, MIC, and PCR. We just made sending of CRE isolates a requirement in 2017. One of the issues (mentioned in another post) is that what you report to a provider for results and what we want as PH are different levels of detail. Our PHL has a committee working with some hospital ID docs to craft what result message will be sent. Plus I don't know how these results will be reported to us at DPH at this point until they get testing established. So that is a "pain" point as it were. We are moving to getting reportable results from the PHL via an xml file that we will process for our end point surveillance system(s).
Notified 36 people