Carbapenem-Resistant Organisms (CRO)

Carbapenem-Resistant Organisms/ Carbapenemase-Producing Organisms (CRO/CPO)

Background

Carbapenem-resistant organisms (CRO) are germs that antibiotics don’t work well against. Examples include E. coli, Klebsiella, and Acinetobacter. Carbapenems are strong antibiotics used for serious infections that don’t respond to other medicines. These antibiotics include ertapenem, imipenem, and meropenem. CRO germs are usually spread by direct contact with infected people, especially through wounds or stool. They can cause infections if they enter the body, often through medical devices like ventilators, IVs, urinary catheters, or wounds from injuries or surgery. To prevent these infections, it’s important to follow safety rules, use the right cleaning products, and make sure staff follow infection control practices.

Public Health Response:

VDH works with healthcare facilities to slow the spread of these dangerous organisms. VDH follows the CDC Guidance for a Public Health Response to Contain Novel or Targeted MDROs. Facilities should collaborate with their local health department on response efforts.

 

 

 

Educational Resources

VDH Infection Prevention and Control Assessments: The HAI/AR team is available to conduct a no-cost, non-regulatory, onsite visit to help a facility identify its infection prevention strengths and areas of opportunity.

Virginia Healthcare-Associated Infections Advisory Group

VCU Virginia Infection Prevention Training Center

 

 

 

Setting-Specific Resources

CDC Interfacility Transfer Form - The patient transfer form helps make it easier to share information when patients are moved between different places for care. Hospitals and groups focused on making patient safety better can change and use this form to fit their needs.

Carbapenem-resistant organism resources specific to hospital settings: 

Carbapenem-resistant organism resources specific to long-term care settings: 

 

 

 

 

 

 

Data & Reporting

Reporting Requirements

Reporting of the following diseases is required by state law (Sections 32.1-36 and 32.1-37 of the Code of Virginia and 12 VAC 5-90-80 of the Board of Health Regulations for Disease Reporting and Control). Report all conditions when suspected or confirmed to your local health department (LHD). Reports may be submitted by Confidential Morbidity Report Portal (Epi-1 form), computer-generated printout, CDC or VDH surveillance form, or upon agreement with VDH, by means of secure electronic submission.

 

 

 

Laboratory Testing

 

 

 

Collaborations

The Emergency Department Care Coordination (EDCC) Program, started in 2017, connects healthcare facilities like hospitals and nursing homes across the state. EDCC now includes alerts for Candida auris and other drug-resistant organisms (MDROs). Since these alerts aren’t updated in real-time and only cover patients known to VDH, facilities should share MDRO status when transferring patients. VDH suggests using the CDC Inter-Facility Infection Control Transfer Form for complete MDRO information. Note: The MDRO flags are an extra tool, not a substitute for direct communication.

Last Updated: December 17, 2025