Nosocomial Infections are hospital-associated or healthcare-associated infections. The Center for Disease Control and Prevention estimates that each year nearly 2 million patients in the United States contract infections in hospitals and about 90,000 of these patients die as a result of their infection.
Staphylococcal bacteria (or staph) can cause serious infections, such as surgical wound infections, blood stream infections and pneumonia. Treatment of staph infections has become more difficult because the bacteria have become resistant to various antibiotics, such as methicillin.
Enterococci are among the leading causes of nosocomial bacteremia, surgical wound infection, and urinary tract infection. Unfortunately, they are becoming resistant to many and sometimes all standard therapies.
The “Missouri Nosocomial Infection Control Act of 2004” mandates that nosocomial methicillin-resistant staphylococcus aureus (MRSA) and nosocomial vancomycin-resistant enterococci (VRE) be included in the list of reportable diseases and/or conditions.
A MRSA VRE Reporting form has been developed as a guide. It is not mandatory to use this form. If the information is available in a different format, and includes all the necessary information, that will be acceptable.
Antibiogram data to be reported shall include nosocomial methicillin sensitive Staphylococcus aureus (S. aureus), nosocomial S. aureus, nosocomial vancomycin sensitive enterococci, and nosocomial enterococci isolates. Data shall be reported directly to the Department of Health and Senior Services. Reporting shall include only a patient's first diagnostic nosocomial isolate per admission of Staphylococcus aureus (S. aureus) and enterococci and the isolates corresponding methicillin or vancomycin sensitivity; irrespective of location or of other anti-microbial sensitivity(ies). Intermediate methicillin or vancomycin sensitivity shall be reported as resistant (i.e., methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE), respectively).
Aggregate data for each quarter will be due within ten days of the end of the quarter (July, August and September data will be due by October 10, 2005). Quarterly aggregate reports shall include only those data that are available within the ten-day reporting period.
A MRSA VRE Reporting form has been developed as a guide. It is not mandatory to use this form. If the information is available in a different format, and includes all the necessary information, that will be acceptable.
MRSA VRE & CRE Reporting - New Process
The Missouri HAI Program is pleased to provide hospitals and ambulatory surgical centers in Missouri a new and improved process for the quarterly reporting of select HAIs. In accordance with 19 CSR 20-20.020, hospitals and ambulatory surgical centers in Missouri are required to report aggregate data on MRSA, VRE, and CRE. The previous method of collecting and reporting this information required facilities to fill out and submit two separate PDF documents by fax or email. The new process using a REDCap survey accessed through a single web link will greatly simplify the reporting and improve the overall quality of the data.
The use of the secure REDCap survey will certainly be an improvement in the quarterly reporting process. The improvements include, but are not limited to, reduced amount of staff time for reporting, as demographic data is prepopulated, yet facilities will easily be able update information as needed; reporting on MRSA, VRE, and CRE using a single link rather than separate submissions; self-checks to ensure accurate data reporting; and the automated distribution of submission confirmation emails so facilities can be assured their information was received. The new process will also make it much easier for the HAI program to utilize the data to help inform a more complete and nuanced picture of the MRSA/VRE/CRE disease burden in Missouri. The link can be used multiple times, if you have multiple facilities to report you will need to complete a survey for each facility separately.
NEW Quarterly Data Reporting Method:
In order to submit your quarterly report, please follow this link: https://redcapdcphlinux.azurewebsites.net/redcap/surveys/?s=T8MWD7YYFLKRC4WK. Once completed, there is an option to have your survey results sent to your email for your records. A confirmation email will also be sent to you. Please feel free to contact the HAI program with questions or concerns about the new process for reporting the select HAIs at HAI_Reporting@health.mo.gov, or by calling 573-751-6113.
Laws, Regulations & Manuals
The rule is effective July 1, 2005. Isolates from cultures performed for routine surveillance purposes are excluded from the requirement to report. Aggregate data for each quarter will be due within ten days of the end of the quarter (July, August and September data will be due by October 10, 2005). Quarterly aggregate reports shall include only those data that are available within the ten-day reporting period.
Each hospital and ambulatory surgical center shall report on a quarterly basis antibiogram data for infection, not colonization, from all body sites monitored by that health care facility. Reporting shall include only a patient's first diagnostic nosocomial isolate per admission. Isolates from cultures performed for routine surveillance purposes are excluded from the requirement to report.
Senate Bill No. 1279, known as the Missouri Nosocomial Infection Control Act of 2004, added the following section to the Missouri Communicable Disease Reporting Rule: 19 CSR 20-20.020 (11)