Extensively Drug-Resistant Organism (XDRO) Registry
The Illinois Department of Public Health has guided development of an infection control tool called the XDRO Registry (www.xdro.org). The purpose of the XDRO Registry is two-fold:
- Improve inter-facility communication: The XDRO Registry primarily allows for CRE information exchange. Health care facilities can query the registry to see whether a patient has been previously reported as CRE-positive.
- Improve CRE surveillance: The registry is capable of storing CRE surveillance data.
As of November 1, 2013, the first CRE-positive culture per patient stay must be reported to the XDRO registry (77 Ill. Adm. Code Part 690 Control of Communicable Diseases Code). Hospitals, hospital-affiliated clinical laboratories, independent or free-standing laboratories, longer-term care facilities, and long-term acute care hospitals in Illinois are required to report CRE isolates that meet surveillance criteria.
CRE surveillance criteria
Enterobacteriaceae (e.g., E. coli, Klebsiella species, Enterobacter species, Proteus species, Citrobacter species, Serratia species, Morganella species or Providentia species) with one of the following laboratory test results:
- Molecular test (e.g., polymerase chain reaction [PCR]) specific for carbapenemase.
- Phenotypic test (e.g., Modified Hodge) specific for carbapenemase production.
- Susceptibility test (for E. coli and Klebsiella species only): non-susceptible (intermediate or resistant) to ONE of the following carbapenems (doripenem, meropenem or imipenem) AND resistant to ALL of the following third generation cephalosporins tested (ceftriaxone, cefotaxime and ceftazidime). Note: ignore ertapenem for this definition.
Consult with microbiology laboratory staff regarding which CRE tests are available. For some laboratories, only #3 will be available.
Additional Information on Reporting
- Illinois Department of Public Health memo to facilities on required reporting of CRE to the XDRO Registry (PDF)
- Flowchart for reporting CRE to the XDRO Registry (PDF)
- XDRO Registry frequently asked questions (PDF)
For more information, check www.xdro.org