CRE Surveillance Case Definition and Reporting - Minnesota Dept. of Health

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.

On this page:
What to report statewide
Sentinel surveillance for Hennepin & Ramsey county residents
Isolate submission and laboratory testing
Reporting rule change: proposal and notification letters

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):
Antibiotic MIC (µg/mL)
Imipenem ≥ 4
Meropenem ≥ 4
Doripenem ≥ 4
Ertapenem ≥ 2

References

  • 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:
Antibiotic MIC (µg/mL)
Imipenem ≥ 8
Meropenem ≥ 8
Doripenem > 1

Isolate submission and laboratory testing

Reporting rule change: proposal and notification letters

Updated Wednesday, December 30, 2015 at 11:24AM