Section 410IAC1-2.5-87. Carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE); specific control measures

   (a) The specific control measures for carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE) (infectious agent: organisms that are nonsusceptible to at least one (1) carbapenem antibiotic with MIC >=2 µg/ml or zone diameter <=22 mm (<=21 mm for ertapenem), and meet one (1) of the following criteria:

(1) Positive for carbapenemase production by a phenotypic test (e.g., Modified Hodge or Carba NP).

(2) Nonsusceptible to at least three (3) carbapenem antibiotics with MIC >=2 µg/ml or zone diameter <=22 mm (<=21 mm for ertapenem).

(3) Positive for a carbapenemase gene marker.)

are listed in subsection (b).

  (b) The specific control measures for carbapenemase-producing carbapenem-resistant Enterobacteriaceae (CP-CRE) are as follows:

(1) An investigation shall be performed by the local health officer within seventy-two (72) hours and include individuals who have shared a residence with the patient in an acute care or long term care facility.

(2) The facility shall initiate contact precautions for CP-CRE; additional precautions should be added if any other transmissible condition is present.

(3) Supplemental measures for a health care facility with CP-CRE transmission include the following:

(A) Refer to the most recent CRE Toolkit from the Centers for Disease Control and Prevention for patient and environmental management of CRE patients.

(B) Consider screening of patients to determine if epidemiologically linked.

(C) Consider chlorhexidine gluconate bathing.

(4) Case definition is established by the department.

(Indiana State Department of Health; 410 IAC 1-2.5-87; filed Nov 25, 2015, 2:54 p.m.: 20151223-IR-410150039FRA)