Communicable Disease Service

Staphylococcus aureus with intermediate-level (VISA) or high-level resistance (VRSA) to vancomycin are must be reported to the local department of health within 24 hours of diagnosis. VISA is S. aureus with a vancomycin MIC >= 4 ug/ml; VRSA is S. aureus with a vancomycin MIC >= 16 ug/ml. Susceptibility levels are defined by according to Clinical and Laboratory Standards Institute's Performance Standards for Antimicrobial Susceptibility Testing; Seventeenth Informational Supplement (M100-S17).

• Q & A on Antibiotics and Antibiotic Resistance
• Resources for Patients
• Resources for Parents
• Resources for Schools, Teachers, and Athletes
• Resources for Healthcare Providers
• Resources for Correctional Facilities
• Resources for Healthcare Facilities

Q & A on Antibiotics and Antibiotic Resistance

1. What are antibiotics?
   Antibiotics are drugs that are designed to kill harmful bacteria in your body. Antibiotics only cure bacterial infections; they do not cure viral infections like a cold, the flu, or a runny nose. It is important to remember that taking antibiotics may increase your risk of getting an antibiotic-resistant infection later.

2. What is an antibiotic-resistant infection?
   Antibiotic-resistant infections happen when bacteria in your body stop responding to the antibiotics meant to kill them. This phenomenon is called antibiotic resistance. Antibiotic-resistant bacteria survive and multiply, causing more harm to the infected person. These bacteria can also share their resistant traits with other bacteria.

3. What can I do to keep myself safe from antibiotic-resistant bacteria?
   As a patient, it is important to remember that antibiotics do not cure viral infections like a cold or the flu. If you are concerned about antibiotic resistance, talk to your doctor to see if there are other options that may help you feel better without antibiotics. If you are prescribed antibiotics, follow your doctor’s instructions completely and continue taking your antibiotics a prescribed, even after you start to feel better. These are important steps to ensuring antibiotic stewardship.

4. What is antibiotic stewardship?
   Antibiotic stewardship is taking action to ensure proper use of antibiotics. Antibiotic stewardship programs are meant to improve antibiotic use through core elements including accountability, action, and education. These programs can decrease antibiotic resistance and improve patient safety and treatment while reducing costs of overprescribing antibiotics. Healthcare facilities like doctors’ offices, urgent care centers, nursing homes, and hospitals are encouraged to implement antibiotic stewardship program.

5. Where can I learn more about antibiotic resistance?
   You can look through the resources provided on this website to learn more about what you can do as a patient, parent, or healthcare provider. Se habla Español? CDC's Infórmese: automedicarse con antibióticos puede perjudicar su salud.

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Resources for Patients

• Infographic: Six Ways to be a Safe Patient (CDC)
• Antibiotics, Good Reasons for Taking Your Pills Correctly - Brochure [English] [Spanish]
• Do You Really Need Antibiotics? Brochure [English] [Spanish]
• Frequently Asked Questions: MRSA

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Resources for Parents

• Pamphlet: Are Antibiotics Necessary? [English] [Spanish]
• Fotonovela: La Hija de Maria se Enferma
• Fotonovela: Una Lección de la Abuelita

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Resources for Schools, Teachers, and Athletes

• Guidance: Strategies for the Prevention of MRSA in Schools: Policy, Infection Prevention, & Education Recommendations
• Website: Teacher’s Room - Childcare and Antibiotics: Know When to Say No (Get Smart PA)
• Fact Sheet: MRSA Fact Sheet for Early Childhood Care and Education Professionals (CDC)
• Publication: 2014-2015 NCAA Sports Medicine Handbook (NCAA, see Guideline J2)
• Fact Sheet: MRSA Fact Sheet for Athletes (CDC) [Basketball] [Football] [Track]
• Poster: MRSA Prevention for Athletes [Baseball] [Soccer] [Basketball] [Football]
• Poster: Practice Good Hygiene for Athletes (CDC, NCAA)
• Poster: Practice Good Health for Athletes (CDC, NCAA)
• Poster: Practice Good Wound Care for Athletes (CDC, NCAA)
• Pamphlet: Preventing MRSA in School and Athletic Settings [English] [Spanish]

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Resources for Healthcare Providers

• Fact Sheet: Preserve the Power of Antibiotics (CDC)
• Pamphlet: Provider Information about MRSA Skin Infections (CDC)
• Flowchart: Outpatient Management of Skin and Soft Tissue Infections in the Era of CA-MRSA (CDC)
• Publication: Strategies for Clinical Management of MRSA in the Community (CDC)

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Resources for Correctional Facilities

• Fact Sheet: Preventing MRSA, Skin Infections
• Poster: Washing Your Hands Stops MRSA (HHS) [English] [Spanish]
• Poster: What is MRSA? (HHS) [English] [Spanish]
• Poster: Handle Laundry Safely (HHS) [English] [Spanish]

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Resources for Healthcare Facilities

• NJDOH MDRO Case Report Form- NEW! 2/28/2022
• NJDOH MDRO Transfer Cover Sheet- NEW! 05/2022
• Document: New Jersey Universal Transfer Form (NJDOH)
• Publication: Core Elements of Hospital Antibiotic Stewardship Programs (CDC) [checklist]
• Publication: Management of Multidrug-Resistant Organisms in Healthcare Settings, 2006 (CDC)
• Publication: Guidelines for Isolation Precautions: Preventing the Transmission of Infectious Agents in Healthcare Settings, 2007 (CDC)
• Publication: Options for Evaluating Environmental Cleaning (CDC)
• Chart: Infection Control Guidelines for the Management of MDROs (NJDOH) [Acute Care Hospitals] [Home Health and Hospice] [Long Term Care Facilities]
• Publication: Evaluation and Research on Antimicrobial Stewardship’s Effect on Clostridium difficile (ERASE C. difficile) Project (AHRQ)
• Publication: Facility Guidance for Control of CRE, November 2015 Update (CDC)
• Publication: CRE Control and Prevention Toolkit (AHRQ) [link] Publication: Laboratory Protocol for Detection of [CRE] from Rectal Swabs (CDC)

• Antibiotic Stewardship Programs
• Continuing Medical Education (CME) Opportunities
• NHSN
• C. Difficile
• MRSA
• Drug-resistant N. Gonorrhoeae
• VISA/VRSA
• VRE

Antibiotic Stewardship Programs

• Publication: Core Elements of Hospital Antibiotic Stewardship Programs (CDC) [Checklist]
  
• Publication: The Core Elements of Antibiotic Stewardship for Nursing Homes (CDC) [Checklist]
• Publication: The Core Elements of Outpatient Antibiotic Stewardship (CDC) [Clinician Checklist] [Facility Checklist]
• Chart: Infection Control Guidelines for the Management of MDROs (NJDOH) [Acute Care Hospitals] [Home Health and Hospice] [Long Term Care Facilities]

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Continuing Medical Education (CME) Opportunities

• Two interactive CME activities with Get Smart New Jersey are available through August 2016: (1) Acute Bacterial Sinusitis in Children and (2) Acute Pharyngitis in Children and Adolescents. Physicians, nurses, and physician assistants are encouraged to take one or both of the modules. Credit will be awarded for successful completion of each program individually.

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NHSN

CDC’s National Healthcare Safety Network (NHSN) is the primary healthcare-associated infection (HAI) tracking system in New Jersey and the nation. NHSN can be used to track MRSA, C. difficile, and other multidrug-resistant organisms within healthcare facilities.

• Web page: NHSN Enrollment for Healthcare Facilities (CDC)
• Web page: Surveillance for Antimicrobial Use and Antimicrobial Resistance Options (CDC)
• Publication: Multidrug-Resistant Organism & Clostridium difficile Infection (MDRO/CDI) Module (CDC)
• Report: Risk-Adjusted Healthcare-Facility Onset C. difficile and MRSA Bacteremia Laboratory-identified Event Reporting in NHSN 2013 (CDC)

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C. Difficile

• Fact Sheet: Frequently Asked Questions about Clostridium Difficile (CDC) [large text]
• Preguntas Frecuentes Clostridium Difficile (CDC)

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MRSA

Methilin-resistant Staphylococcus aureus (MRSA) reporting into NHSN is currently required for all acute care hospitals in New Jersey. At a minimum, each facility must be monitoring MRSA LabID Event BSIs at the facility-wide level and conducting MRSA Admission AST to and the adherence rate in at least one high-risk patient care area (i.e., a patient care area where patients have an increased likelihood of acquiring MRSA and/or developing severe clinical outcomes resulting from a MRSA infection).

• Guidance: Strategies for the Prevention of MRSA in Schools: Policy, Infection Prevention, & Education Recommendations (NJDOH)
• Fact Sheet: MRSA
• Fact Sheet: MRSA (CDC)
• Fact Sheet: Frequently Asked Questions about MRSA (CDC) [large text]
• List: EPA’s Registered Products Effective against MRSA and VRE (EPA)
• Hojia De Información Básica Sobre El SARM (CDC)
• Preguntas Frecuentes "MRSA" (CDC)

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Drug-resistant N. Gonorrhoeae

• Fact Sheet: Gonorrhea CDC (CDC)
• Fact Sheet: Antibiotic Resistance Solutions Initiative: Gonorrhea (CDC)
• Gonorrea: Hoja informativa de los CDC (CDC)

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VISA/VRSA

Staphylococcus aureus with intermediate-level (VISA) or high-level resistance (VRSA) to vancomycin are must be reported to the local department of health within 24 hours of diagnosis. VISA is S. aureus with a vancomycin MIC >= 4 ug/ml; VRSA is S. aureus with a vancomycin MIC >= 16 ug/ml. Susceptibility levels are defined by according to Clinical and Laboratory Standards Institute's Performance Standards for Antimicrobial Susceptibility Testing; Seventeenth Informational Supplement (M100-S17).

• Investigation and Control of VRSA, 2015 Update (CDC)

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VRE

• Fact Sheet: Frequently Asked Questions about Vancomucin-Resistant Enterococcus (CDC)
• List: EPA’s Registered Products Effective against MRSA and VRE (EPA)