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Louisiana Department of Health & Hospitals | Kathy Kliebert, Secretary

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Statewide Initiatives



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Antibiotic Sensitivity - Services

The Surveillance System

There are two components to the Emerging Pathogens Surveillance System. First, the Microbiology laboratory should report the total number of Staphylococcus aureus, Streptococcus pneumoniae, and Enterococcus species isolated in their lab for each month. Among these isolates, the total number of drug resistant or drug intermediate resistant isolates should be reported. Please do not count duplicate isolates on a patient (one isolate of MRSA, VRE, or DRSP per patient per hospital visit). Enclosed please find a copy of the Aggregate Laboratory Data form. This form is to be filled out and returned to the Infectious Disease Epidemiology Department by the 20th of the next month. For instance, January data should arrive by the 20th of February. A quarterly and annual report of the cumulative data by public health region and statewide will be sent to you.

The second component involves the reporting of newly acute infections by the Infection Control Practitioner. This can be accomplished by sending in a confidential disease report card (Epi 2430 card) through normal communicable disease reporting channels; for example, mailing, faxing, phoning, or electronically using the access based software program. Colonizations should not be reported on green cards.

Antibiotic Resistance - Resistance of common antibiotics is increasingly becoming a problem. These antibiotics work by affecting the cell wall, distorting the cell surface, inhibiting bacterial protein synthesis, or preventing DNA formation. Some bacteria are able to adapt survival mechanisms against these agents, thus weakening our ability to control disease. Surveillance systems have been initiated in an attempt to track emerging resistant strains. This information will lead to a better understanding of the pathogens and potential treatments. As aforementioned, Louisiana is monitoring the following three organisms.

Methicillin Resistant Staphylococcus aureus - Staphylococcus aureus is commonly found in the nasal cavity, perineum, anal area, finger tips, among others. A fraction of these people are colonized with MRSA while others are acutely ill. Methicillin resistance to S. aureus is primarily due to the organism's ability to produce b lactamase, which is capable of breaking down the penicillin ring thus making it ineffective. Acquisition of MRSA infections is a common concern among both patients and staff in acute and long-term care facilities. By tracking MRSA, the Office of Public Health can continue to assist in monitoring the rate of serious MRSA infections and any vancomycin resistant S. aureus that may arise.

Drug Resistant Streptococcus pneumoniae - Streptococci are important agents of human disease, colonizers in the human flora, and agents of animal disease. S. pneumoniae is the most common cause of community acquired pneumonia both in children and adults. It causes approximately half of otitis media cases and it is very frequently the culprit of meningitis and sepsis. This human pathogen is commonly treated with penicillin; however, similar to many other organisms, S. pneumoniae has been reported to have a high resistance to penicillin.

Vancomycin Resistant Enterococcus - Vancomycin resistant enterococcus is ubiquitous in the hospital environment, often found as a contaminant on medical equipment. Most patients are simply colonized and not infected (a ratio of 10:1). Persons at highest risk for VRE infections are those hospitalized with severe underlying or immunosuppressive conditions. These people may be affected by one of two mechanisms: drug resistance developed post-exposure to the antibiotic or via contact with the drug resistant pathogen (person to person or environmental).

Louisiana collects data on unspeciated strains, as well as E. faecalis and E. faecium.

 

Primary Contact Information:

Antibiotic Sensitivity Program: Lauren Elmendorf, MPH
Address:
1450 Poydras Street, Ste. 2162-B
New Orleans, LA 70112

Telephone: (504) 568-8318
Fax: (504) 568-8290
Email: lauren.elmendorf@la.gov