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

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. 

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Resources for Patients

• Antibiotics, Good Reasons for Taking Your Pills Correctly - Brochure [English] [Spanish]
• Do You Really Need Antibiotics? Brochure [English] [Spanish]
• CPO Patient FAQs (NJDOH)
• CPO Patient Discharge Information (NJDOH)

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Resources for Parents

• Pamphlet: Are Antibiotics Necessary? [English] [Spanish]

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Resources for Healthcare Facilities

• NJDOH MDRO Epidemiological Assessment
• NJDOH MDRO Transfer Cover Sheet
• Document: New Jersey Universal Transfer Form (NJDOH)
• 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: CRE Control and Prevention Toolkit (AHRQ)
• Publication: Laboratory Protocol for Detection of [CRE] from Rectal Swabs (CDC)

• NHSN
• C. Difficile
• VISA/VRSA

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

• Clostridioides difficile (C. diff) (CDC)

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VISA/VRSA

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