CRE Disease Reporting and Surveillance Case Definition

In 2011, as part of the Emerging Infections Program, MDH initiated population-based laboratory surveillance for CRE in Ramsey and Hennepin Counties. CRE is not reportable under the Minnesota Communicable Diseases Reporting Rule.

On this page:
What to report
Who should report

How to report

Submitting clinical materials

What to report: CRE surveillance definition

  • Enterobacteriaceae that meet the following criteria should be considered as having met the surveillance definition:
    • Intermediate* or resistant* to imipenem, meropenem, or doripenem; AND
    • Resistant* to all tested third generation cephalosporins.
  • Some isolates of Proteus spp., Providencia spp., and Morganella morganii may have different resistance mechanisms that result in elevated imipenem MICs. Therefore, submit these isolates ONLY if they meet the following criteria:
    • Intermediate* or resistant* to at least two carbapenem antibiotics (ertapenem, imipenem, meropenem, or doripenem); AND
    • Resistant* to all tested third generation cephalosporins.

*Carbapenem and third generation cephalosporin interpretive criteria are based on the current Clinical and Laboratory Standards Institute guidelines.

Who should to report

  • Healthcare providers and laboratories in Hennepin and Ramsey Counties are required to report cases of CRE (patients who are infected or colonized with CRE) to the Minnesota Department of Health.
  • All laboratories outside Hennepin and Ramsey Counties are strongly encouraged to voluntarily report CRE to MDH and submit CRE isolates to MDH PHL.

How to report

  • Yellow Card
    The MDH "Yellow Card" (previously known as the "blue card") can be used to report CRE cases in Minnesota residents to the Minnesota Department of Health .
  • Submit CRE isolates to MDH PHL.
  • Infection preventionists/physicians should notify MDH-Epidemiology when a specimen is submitted (651-201-5414 or 1-877-201-5414) or if you have reporting questions.

Submitting clinical materials

References

Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Third Informational Supplement (January 2013). CLSI document M100-S23. Wayne, Pennsylvania, 2013.

Updated Friday, 31-May-2013 09:07:02 CDT