Targeted Multidrug-resistant Organism Prevention and Response Toolkit

Toolkit Overview

Antibiotic resistance is a threat to everyone. Healthcare facilities should establish and follow policies for prevention and management of MDROs (MDRO risk assessment). The Washington State Department of Health supports and guides prevention and response efforts for certain uncommon MDROs to protect patients and prevent spread.

This toolkit provides organism-specific guidance and educational resources for Washington healthcare providers, healthcare facilities, and local health jurisdictions (LHJs) to prevent, detect, and contain targeted MDROs.

Targeted MDROs in Washington

The  toolkit provides guidance for investigation and control activities for the following targeted organisms:

Candida auris 

Candida auris (C. auris) is a fungus that can cause serious infections. It is often multidrug-resistant, can spread in hospitals and nursing homes, and is associated with a high mortality rate. C. auris is difficult to identify with standard laboratory methods which delays detection and measures to prevent spread.

Carbapenemase-producing Organisms (CPO) e.g., KPC, NDM, VIM, IMP, OXA-48, OXA-23, OXA-24/40, OXA-58 or OXA-235) 

Carbapenemase producing organisms (CPO) including Enterobacterales such as Escherichia, Klebsiella, and Enterobacter; Pseudomonas aeruginosa; and Acinetobacter baumannii. CPO can cause serious infections. These bacteria can spread outside the gut and can be very difficult to treat.

Vancomycin-resistant Staphylococcus aureus (VRSA)  

Vancomycin-intermediate Staphylococcus aureus and Vancomycin-resistant Staphylococcus aureus (VRSA) are types of antibiotic-resistant bacteria. Staphylococcus aureus is a bacterium that can cause infections that may be fatal.

Pan-resistant Organisms

Pan-resistant Organisms: defined as an organism is not susceptible to any of the antimicrobial drugs tested.

Please note CDC Containment and Prevention Strategy classifies targeted MDROs into tiers 1, 2 and 3.  Washington classifies all carbapenemases, including KPC and OXA, and Candida auris as Tier 2. 

Targeted MDRO Resources

Public Health Response & Guidelines 

Healthcare Facility Education and Infection Prevention

Patient/Family Education & Notification 

Fact Sheets

Screening and Laboratory Testing

Links and documents related to isolate submission, testing and response screening.