Information Collection

57.126 MDRO or CDI Infection Event

IC 183561 under ICR 201407-0920-007 · OMB 0920-0666.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0666 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CDC 57.126 57.126 MDRO or CDI Infection Event	Form
CDC 57.126 MDRO or CDI Infection Event 57.126_MDROInfectionEvent_BLANK.docx	Form
Att G.14_MDRO CDI.pdf Att G.14 Multidrug-Resistant Organism & Clostridium difficile Infection (MDRO/CDI) Module	IC Document

IC Title:

57.126 MDRO or CDI Infection Event

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CDC 57.126	MDRO or CDI Infection Event	57.126_MDROInfectionEvent_BLANK.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6,000

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	432,000	0	432,000
Annual IC Time Burden (Hours)	216,000	7,200	208,800
Annual IC Cost Burden (Dollars)	7,900,992	0	7,900,992

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att G.14 Multidrug-Resistant Organism & Clostridium difficile Infection (MDRO/CDI) Module	Att G.14_MDRO CDI.pdf	08/25/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.