CRE Surveillance Case Definition and Reporting
Starting January 1, 2016 Carbapenemase Resistant Enterobacteriaceae (CRE) will be reportable statewide under the Communicable Disease Rules, Chapter 4605. CRE reporting is slightly different for residents of Hennepin and Ramsey Counties.
What to report statewide
- Enterobacteriaceae of the following species Klebsiella spp., Enterobacter spp., E.coli, or Citrobacter spp., isolated from any body site, that meet the following criteria:
- Resistant to imipenem, meropenem, doripenem or ertapenem based on current Clinical and Laboratory Standards Institutes Standards (CLSI) M100 standards; and/or
- That demonstrate production of a carbapenemase by a recognized method (e.g. Modified Hodge Test or PCR).
- All laboratories are strongly encouraged to report and submit isolates of other Enterobacteriaeae species if resistant to any carbapenem antibiotic.
- Current CLSI minimum inhibitory concentration (MIC) interpretive criteria for carbapenem-resistant Enterobacteriaeae (CRE):
- Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fourth Informational Supplement (January 2014). CLSI document M100-S24. Wayne, Pennsylvania, 2014.
Sentinel surveillance for Hennepin and Ramsey county residents
- In addition to CRE, also report Acinetobacter baumanii, that meet the following criteria:
- Nonsusceptible (intermediate or resistant) to imipenem, meropenem, or doripenem based on these MIC interpretive criteria:
Isolate submission and laboratory testing
- CRE Isolate Submission and Laboratory Testing
Information about submitting isolates to MDH PHL.
Reporting rule change: proposal and notification letters
- Proposal for Conducting Statewide Surveillance for Carbapenem-resistant Enterobacteriaceae (CRE) in Minnesota under the Minnesota Communicable Disease Rule (4605.7080) (PDF)
The proposal explaining the rationale for this change.The commissioner of health has the authority to make this change to the reporting rules per Minn. Rules 4605.7080.
- Minnesota State Register Monday 11 January 2016 Volume 40, Number 28 (PDF)
Official Notices: Report of Carbapenem-resistant Enterobacteriaceae (CRE) under the Minnesota Communicable Disease Rules, Chapter 4605.7080, page 782. Attn: Non-MDH link.
- Commissioner’s letter to Minnesota laboratories regarding CRE surveillance, January 8, 2016 (PDF)
- Commissioner’s letter to Minnesota infection preventionists regarding CRE surveillance, January 8, 2016 (PDF)