355Carbapenem-Resistant Enterobacteriaceae (CRE) Distribution within the Veterans Affairs Healthcare System: 2013

Background. The Centers for Disease Control and Prevention (CDC) has reported national trends for hospital-acquired infections with CRE. Utilizing the Department of Veteran’s Affairs (VA) Healthcare-Associated Infections and Influenza Surveillance System (HAIISS), we sought to describe isolation of CRE among Veterans cared for nationally at inpatient and outpatient VA healthcare settings from January December 2013. Methods. We queried the HAIISS Data Warehouse for all isolates of Enterobacteriaceae meeting CDC criteria: • Nonsusceptible to one of the following carbapenems: doripenem, meropenem, or imipenem AND • Resistant to all of the following third-generation cephalosporins that were tested: ceftriaxone, cefotaxime, and ceftazidime. CRE were isolated in VA using standard microbiologic methods. Duplicate isolates were eliminated unless they were isolated in more than one specimen type category. Results. A total of 528 unique isolates meeting CDC criteria for the one year time period were isolated (table). Klebsiella (64%) and Enterobacter (16%) species were most common. The primary specimen types associated with CRE were urine, respiratory, and blood, with 359 (58%), 102 (16%), and 53 (9%) isolates respectively. The remaining 106 (17%) CRE isolates were from a variety of other specimen types. [1] MMWRMarch 8, 2013/62(09);165-170 Vital Signs: Carbapenem-Resistant Enterobacteriaceae