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Oregon Health Authority

Multidrug-Resistant Organisms

CPOs and C.auris Prevention

Multidrug-resistant organisms (MDROs) are a growing problem globally, and an emerging threat in Oregon. Carbapenemase-producing organisms (CPO) are an epidemiologically important group of multidrug-resistant pathogens classified by the Centers for Disease Control and Prevention (CDC) as an urgent threat to public health. Infections caused by CPO are difficult to treat and associated with high mortality. 

Another focus is Candida auris (C. auris), a fungus that can colonize the skin, cause invasive infections, and has demonstrated resistance to common antifungal drugs. Some strains are resistant to all available classes of antifungals. It can spread readily among patients in healthcare facilities and persists for long periods of time in the environment or on contaminated medical equipment, causing numerous outbreaks that have been difficult to control. 

Early detection and implementation of infection prevention and control strategies are imperative to prevent further spread of CPOs and C. auris. 

Our Comprehensive Approach:

  • Surveillance and Assessment: We collaborate closely with healthcare facilities in Oregon to conduct regular point prevalence surveys and infection control assessments. 
  • Targeted Screening: We work with facilities to implement screening procedures for patients at elevated risk of carrying CPOs and C. auris. 
  • Containment and Response: If a patient with an MDRO, CPO, or C. auris is detected, we support healthcare facilities to rapidly implement containment and response measures. 
Our goal is to safeguard public health by mitigating the spread of these resistant germs. Through our collaborative efforts, we can reduce their impact on patient well-being and health care safety. 

Admission Screening Recommendations


What are the recommendations?
C. auris and CPOs are rare but serious drug-resistant infections. We are asking healthcare facilities to take proactive steps to protect Oregonians by screening patients when they are admitted for an overnight stay and testing those that meet the criteria.

Testing is provided at no cost to facilities or patients.

Who does it apply to?

  • Acute Care Hospitals (ACHs)
  • Long-term Acute Care Hospitals (LTACH)
  • Ventilator-capable Skilled Nursing Facilities (vSNFs)

These facility types are most likely to encounter people who are at highest risk of acquiring C. auris or a CPO.

Why are we recommending it?
Finding these germs early allows healthcare staff to take steps to prevent the spread of these germs and keep other patients safe. In Oregon these germs are rare, but in other parts of the country, these germs are much more prevalent. These germs are hard to treat and can cause serious illness and death, so screening patients early will help us prevent more infections and keep these germs from spreading in Oregon facilities.

Contact us to get started!

Tools

DROP-CRE Network

Drug-Resistant Organism Prevention and Coordinated Regional Epidemiology (DROP-CRE) is a unique public-academic partnership whose goal is to detect and contain multidrug-resistant organisms (MDROs) in Oregon.

Goals

  • Monitor Oregon antimicrobial resistant (AR) organism epidemiology
  • Assess the needs and capabilities for response
  • Coordinate statewide education about AR organisms
  • Develop laboratory capacity for rapid detection of AR organisms, and
  • Provide outbreak assistance.

Members

  • Oregon Health and Science University
  • Portland Veteran’s Administration (VA)
  • Oregon Health Authority’s Public Health Division
  • Regional laboratories and hospitals
  • Oregon Association for Professionals in Infection Control (APIC).

Activities

The network was first established in 2012 and developed the first Oregon Carbapenem-Resistant Enterobacterales (CRE) toolkit. It has conducted surveys of laboratories, infection preventionists, and long-term care facilities and has provided education through presentations, webinars, and guidance documents. The network assists with prevention and response to important MDROs in our state, including carbapenem-resistant and carbapenemase-producing organisms and Candida auris.

Resources

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