Healthcare-Associated Infection and Antibiotic Resistance

Surveillance and Investigation

Arizona Administrative Code requires laboratories and healthcare providers to report selected organisms to ADHS, some of which are associated with antibiotic resistance or HAIs. These include invasive methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-intermediate and vancomycin-resistant Staphylococcus aureus (VISA/VRSA), Vancomycin-resistant Staphylococcus epidermidis (VRSE), and Streptococcus pneumoniae.

ADHS is working with partners through the multidisciplinary HAI Advisory Committee to develop strategies for enhancing HAI surveillance in the state. Below are some resources that may be helpful for healthcare providers and local health departments in their efforts to monitor and investigate HAIs and antibiotic resistant infections.

ADHS Surveillance and Investigation Resources

• Case Definitions for Public Health Surveillance
• Communicable Disease Reporting
• Infectious Disease Investigation Manual

External Surveillance and Investigation Resources

On Friday, July 30th, the Centers for Medicare and Medicaid Services (CMS) released its final rule for the 2011 Hospital Inpatient Prospective Payment System (IPPS). This rule will require all hospitals participating in the Medicare program to report information on selected healthcare-associated infections (HAIs) through the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN). Specifically, hospitals must report:

• Central line associated bloodstream infections (CLABSI) beginning with January 1st, 2011 discharges for Medicare reimbursement beginning in FY 2013.
  
  
• Surgical site infections (SSI; procedures currently unspecified) beginning with January 1st, 2012 discharges for Medical reimbursement beginning in FY 2014.

This data will be reported out publically through the CMS Hospital Compare website. Facilities not submitting data in accordance with the final rule will be subject to reductions in their Medicare Annual Payment Update.

Please see the links below for NHSN information and trainings.

General National Healthcare Safety Network (NHSN) Information

• NHSN main page
• About NHSN
• New to NHSN? - Introduction to NHSN for new users
• CDC NHSN Resource Library - includes NHSN guides, NHSN codes and variables, manuals for each NHSN component

NHSN Enrollment Information

• NHSN enrollment main page
• Begin enrollment process
• Enrollment training - webinar training lectures
• Enrollment forms

NHSN Training

• NEW! Arizona NHSN Training Series Materials
• Data entry, surveillance, and analysis webinars
• Device-associated module training - includes CLABSI, VAP, and CAUTI
• Procedure-associated module training - includes SSI
• CDC NHSN training library

Electronic Upload of Data

NHSN has been enabled to accept electronic infection reports, denominator data, and process of care data from commercial infection surveillance systems. To implement clinical document architecture (CDA) for NHSN, please contact your Infection Control Software vendor. CDC provides more information on electronic upload of data here.