The Healthcare-Associated Infection/Antibiotic Resistance (HAI/AR) Prevention Program aims to lớn eliminate và prevent HAIs & AR organisms.

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Facilitate evidence-based practices for infection prevention and control in healthcare settings through education & training, consultation and access to lớn resource materials.

Required Reporting-Updated

HAIs and MDROs reporting regulation - 902 KAR 2:020 Reportable disease surveillance .

Changes in reporting requirements for all MDROs have been made.

Reporting within one business day of:Candida auris withConfirmatory lab evidence (PCR or culture)EPID 250 (fax 502-398-2462)Reporting within one business day with EPID 250 (fax (502) 398-2462) and labs with MIC values of:Carbapenem-resistantAcinetobacterEnterobacteriales (Enterobacteriaceae)PseudomonasVancomycin-intermediate Staphylococcus aureus (VISA)Vancomycin-resistant Staphylococcus aureus (VRSA) Electronic lab reporting within five days is required for (no EPID 250 required): Clostridioides difficile (C. Difficile)Enterobacteriales (Enterobacteriaceae) species resistant lớn ceftazidime, ceftriaxone or cefotaxime  (ESBL)Methicillin-resistant Staphylococcus aureus (MRSA)Vancomycin-resistant Enterococcus species (VRE)

What is an HAI?

HAIs are infections patients develop while receiving healthcare. HAIs can occur in all health settings including, but not limited to, hospitals, ambulatory surgical centers, dialysis facilities, outpatient clinics e.g., physicians" offices, health care clinics , rehabilitation centers and nursing homes. HAIs can be associated with procedures and the devices used in medical care and treatment.

Common HAIs include: central line associated bloodstream infection, catheter-associated urinary tract infection, surgical site infection, Clostridioides difficile and methicillin-resistant Staphylococcus aureus infections.

What is Antimicrobial Resistance?

Antimicrobial/antibiotic resistance occurs when germs like bacteria và fungi have or develop the ability to defeat the drugs designed to lớn kill them. Infections caused by antibiotic-resistant germs are difficult and sometimes impossible, to lớn treat. Consequently, antibiotic-resistant infections can extend hospital stays & require additional follow-up doctor visits và costly, toxic alternative therapies.

Antibiotic resistance does not mean a person is resistant to antibiotics, but, rather, bacteria have become resistant lớn antibiotics designed khổng lồ kill them. To lớn survive, germs are constantly finding new defense strategies khổng lồ survive the effects of antibiotics.

Bacteria develop resistance through traits in their DNA. Often, resistance genes are found in DNA that carry genetic instructions from one germ khổng lồ another. Some bacteria can share their DNA & make other germs resistant. More in-depth information can be found

Browse more in-depth information about antibiotic resistance

Regional Infection Preventionists

to better assist in the response khổng lồ the COVID-19 pandemic, the department recently added regional infection preventionists. These regional IPs work with facilities in the local communities khổng lồ help respond to & control the spread of COVID-19 in the healthcare setting. is divided into 10 regions, each with a regional infection preventionist. See maps and table below for liên hệ information. *Region 3 regional IP is currently vacant, the counties in this region are being covered by other regional IPs. 


Region Name and email link Title Work Cell
N/A Mary FisterAdmin SpecialistN/A
N/A Ruth BelflowerRegional IP Coordinator(502) 871-2628
1 Pat LewisRegional IP(502) 871-2350
2 Lana NewkirkRegional IP(502) 871-2632
3VacantRegional IP 
4 Betty ProchaskaRegional IP(502) 871-2625
5 Jennie LongRegional IP(502) 871-2349
6 Mattheus SmitRegional IP(502) 871-2631
7 Komal GurjarRegional IP(502) 871-2347
8 Cheryl HooperRegional IP(502) 871-2627
9 Naomi WilliamsRegional IP(502) 871-2630
10 Linda SmitRegional IP(502) 871-2629 State-Regional Infection Prevention và Epidemiology Regional Infection Prevention và Epidemiology advises the HAI/AR Prevention Program. Hospital Association is a long-term partner of the HAI/AR Prevention Program, working on issues of infection prevention & control in acute care and critical access hospitals and providing education to lớn infection preventionists in 

More information about the program can be found in the State nhị Plan .


Multi-drug resistant organisms MDROs are common germs, usually bacteria, resistant to multiple antibiotics. MDROs can cause active infections with or without symptoms.

MDROs commonly spread by direct tương tác between people or with contaminated surfaces in the environment. MDROs can be difficult to lớn treat, depending on the antibiotics lớn which the bacteria are resistant.

MDRO Reporting

MDRO reporting has been required since năm nhâm thìn and involves completing the multidrug-resistant reporting form EPID 250​ & providing the associated laboratory results. Instructions for filling out the EPID 250 are provided, as are more in-depth definitions for carbapenem-resistant organisms.

The MDRO Reporting mandate has been updated. Please see updated version above.

New Recognized Infectious Agents, hai Outbreaks, Emerging Pathogens & Pathogens of Public Health Importance

An outbreak of a disease or condition that resulted in multiple hospitalizations or death is expected to lớn be reported immediately by phone to lớn the Department for Public Health.

An unexpected pattern of cases, suspected cases or deaths which may indicate a newly-recognized infectious agent; an outbreak or epidemic; an emerging pathogen posing a public health danger; or a non-infectious chemical, biological or radiological agent. These events are lớn be reported to the Department for Public Health by phone.

Outbreaks and Investigations

As reports are processed the HAI/AR Prevention Program will conduct outbreak investigations when indicated. An nhị outbreak is defined as: the occurrence of two or more HAIs or MDROs epidemiologically linked or connected by person, place or time; or a single case of an nhị not commonly diagnosed. An investigation also may occur if a specific nhị or MDRO is found in a location for the first time.


Investigations are traditionally focused on outbreaks of MDROs và emerging pathogens. Additionally, there have been investigations related khổng lồ infections occurring related lớn devices e.g., intrathecal pain pumps & outpatient procedures intra-articular joint injections. Site visits are conducted when possible. We engage CDC when emerging pathogens/mechanisms are identified. We use the Division of Laboratory Services & CDC lab for pulsed field gel electrophoresis và whole-genome sequencing when needed.

Point Prevalence Survey

A point prevalence survey (PPS) involves screening at-risk individuals when there is concern for potential horizontal transmission of MDROs between patients either directly or via healthcare providers. The Antibiotic Resistance Laboratory Network provides assistance when PPS are performed. The AR Lab Network national initiative is funded through CDC grants.

If within-facility transmission is identified or suspected, PPS will continue until transmission is halted. Additionally, a targeted onsite assessment will be performed if possible và assistance provided to the facility khổng lồ mitigate breaches of infection prevention & control. Re-emphasis on facility infection prevention và control activities always is part of the response.

Target Infections Control Assessment và Response

Infection Control Assessment Tools were developed by CDC under the Epidemiology and Laboratory Capacity Infection Control Assessment and Response Program to help health departments assess infection prevention practices & guide chất lượng improvement activities, such as addressing identified gaps. These tools also may be used by healthcare facilities to lớn conduct internal unique improvement audits.


What is NHSN?

The CDC National Healthcare Safety Network is a national hai tracking system that provides data to identify problem areas, measure progress of prevention efforts and ultimately eliminate healthcare-associated infections.

The network allows healthcare facilities to lớn track HAIs as well as blood safety errors và important healthcare process measures such as healthcare personnel influenza vaccine status & infection control adherence rates.

Target, Assess and Prevent

The Targeted Assessment for Prevention (TAP) Strategy is a framework for quality improvement developed by the CDC to lớn use data for kích hoạt to prevent HAIs. The TAP Strategy consists of three components: 1. Running TAP reports in the National Healthcare Safety Network (NHSN) to lớn target healthcare facilities & specific units with an excess burden of HAIs; 2. Administering TAP facility assessment tools khổng lồ identify gaps in infection prevention in the targeted locations; and 3. Accessing infection prevention resources in TAP implementation guides to address those gaps. The TAP assessment survey is administered to a variety of people in the hospital to identify breaches in knowledge for specific infection control practices and activities.

The Statewide Annual TAP Report is available for the years 2015-2017 và the year 2018-2020 is expected September 2021 .

Extensively Drug Resistant Organism Registry

The XDRO registry is populated with patient information & laboratory data for all carbapenem-resistant Enterobacteriaceae CRE identified in facilities or identified in residents. The registry can be queried by facility infection preventionists lớn support appropriate transmission-based precautions when patients have healthcare contact. Initial entry in the XDRO registry is made manually by the HAI/AR Prevention Program staff, although eventually the registry will be populated automatically from electronic laboratory reporting through the Health Information Exchange (KHIE) . Additionally, an alert feature is planned to allow real-time use of admission, transfer và discharge data in KHIE to lớn alert facilities of patient CRE history. This will provide more timely initiation of appropriate transmission-based precautions và limit opportunities for spread of the organism in the facility.

If you are interested in gaining access khổng lồ the database please liên hệ Brittany Corley .

Antimicrobial Stewardship

According to SHEA , antibiotic stewardship involves coordinated strategies to improve use of antimicrobial medications to lớn enhance patient health outcomes, reduce resistance to antibiotics & decrease unnecessary costs.

Antimicrobial stewardship includes a systematic effort to educate and persuade prescribers of antimicrobials khổng lồ follow evidence-based prescribing.

Statewide antimicrobial stewardship report 2013-14


ActivitiesThe Louisville-Metropolitan Antimicrobial Resistance/Antibiotic Stewardship Collaborative serves as a vehicle for discussion of issues related lớn infection prevention & control, antimicrobial resistance and antibiotic stewardship. Participants include physicians, infection preventionists, microbiologists & others from acute and long-term care facilities in the Louisville metropolitan area. Goals include strengthening inter-facility communication & improving consistency of response lớn antimicrobial resistance threats. Southeastern Regional Collaborative brings together healthcare facilities in the region to discuss issues of infection prevention, antibiotic resistance and interfacility communication Work with Alliant unique is a quality-improvement group for Alliant Health Solutions.The hospital-onset HO MRSA Bloodstream Infection Collaborative with CDC and Tennessee is an effort to reduce rates of MRSA bacteremia in facilities with historically higher rates through targeted evidence-based interventions. Hospital Association is a long-term partner of the HAI/AR Prevention Program, working on issues of infection prevention & control in acute care and critical access hospitals và providing education lớn infection preventionists in Work with the Child và Adolescent Health Research thiết kế and tư vấn Unit CAHRDS Antibiotic Team, Department of Pediatrics, University of Louisville School of Medicine. This group analyzes Medicaid prescribing và claims data related to lớn antibiotic prescribing in pediatrics lớn improve outpatient antibiotic prescribing for pediatric patients across the state. More generally, it actively is involved in increasing public và provider knowledge about antibiotic use và antimicrobial resistance as critical public health issues.

Frequently Asked Questions

What is the difference between an active infection and colonization with an organism?

Active infection indicates an organism (bacteria, virus, etc.) is found in or on the body toàn thân and is associated with signs and/or symptoms of illness. Colonization indicates that an organism is found in or on the body but is not producing signs or symptoms of illness.

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Are liên hệ precautions necessary in long-term care?

According to the CDC place CRE colonized or infected residents that are high-risk for transmission on CP. For patients at lower risk for transmission use precautions based on type of care provided.