Form 0920-0978 MRSA SO Supplemental Survey

Form approved
OMB No. 0920-0978
Expires xx/xx/xxxx

2019 HAIC Invasive Staphylococcus aureus Supplemental Surveillance Officer Survey
Please answer the following questions for the year 2018. The purpose of the survey is to verify and
document current surveillance procedures, including cases ascertainment and auditing methods. Please
return an electronically completed copy or scanned copy of the completed survey to [email protected]. If you
have any questions, please contact Kelly Jackson ([email protected]).

Site: ___ CA ___ CT ___ GA ___ MD ___ MN ___ NY ___ TN
Person(s) Completing the Form: ___________________________
Surveillance Area Characteristics
1.

Is MRSA reportable at your site? _______ yes
_______ no
a. If yes:
i. What is your reportable definition of MRSA?
_______ All invasive MRSA statewide
_______ Invasive MRSA in residents among defined catchment area
_______ Healthcare-associated invasive MRSA infection
_______ Other, please define: ___________________________________
ii. Is isolate submission to the State Health Department Laboratory required?
_______ yes
_______ no
b. If no:
i. What mechanism do you have in place that allows for SOs to have access to case
counts and medical records?
_______ Agent of the state
_______ State Health Department Regulation
_______ Other, please explain: __________________________________
ii. Does your state/site plan to make MRSA reportable? ______yes _______no

2. Did your site send MRSA isolates to CDC for characterization in 2017? ______yes _______no
a. If yes, how were isolates selected? ___________________________________________
___________________________________________________________________________
___________________________________________________________________________
3. How does your site complete SA case report forms (please select all that apply)?
_______On a computer or tablet
_______With paper and pen
_______Other, please explain: ________________________________
4. Did your site participate in MSSA surveillance in 2017? ______yes _______no
a. If yes, what mechanism did you have in place that allowed for SOs to have access to
MSSA case counts and medical records?
_______MSSA is a reportable condition
_______ Agent of the state
_______ State Health Department Regulation
_______ Other, please explain: __________________________________
Public reporting burden of this collection of information is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not
required to respond to a collection of information unless it displays a current valid OMB control number. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Rd NE, MS D-74, Atlanta, Georgia 30329;
ATTN: PRA (xxxx-xxxx)

b. If yes, please complete the date range for which MSSA surveillance was conducted in
2017 (month/year) as well as the catchment area:
2017

Dates of MSSA surveillance
Catchment area

5. Are you able to directly access any National Healthcare Safety Network (NHSN) data?
_______ yes
_______ no
a. If yes:
i. Please mark which NHSN data your site can access
_______ Hospital MRSA LabID event
_______ Hospital central line-associated bloodstream infection (CLABSI) data
_______ Dialysis event

b. If no:
i. Does a public health partner have access to NHSN data?
For example, if your site is not based at the state HD does the state HD have
access to the data? If your site is part of the state HD and you do not have direct
access to the NHSN data, does another department/section have access to the
data?
_______ yes
_______ no
1. If yes:
a. Please mark which NHSN data can be accessed
_______ Hospital MRSA LabID event
_______ Hospital CLABSI data
_______ Dialysis event
3. How often do you access/are you provided with NHSN data?
_______ Weekly
_______ Monthly
_______ Never
_______ Other, please specify ___________________________________
4. What do you use NHSN data for?____________________________________________________
_________________________________________________________________________________

Lab Participation and Case Finding
Please answer the following questions for hospitals and labs under surveillance for 2017.
1. Please list the total number of each type of lab serving your MRSA surveillance catchment area
(both inside and outside of the catchment area):
Inside catchment area

Outside catchment area
Hospital laboratories
Dialysis referral laboratories
Commercial/outpatient laboratories*
Other; please specify:_______________________________
Total number (Add above together)

*For the purpose of the survey, we are defining “Commercial/Outpatient Laboratories” as any for profit laboratory, not including dialysis referral
laboratories, that serve health care facilities in a given surveillance catchment area. Examples include LabCorp and Quest.

2.

Please list the total number of each type of lab serving your MSSA surveillance catchment area if
different catchment than MRSA (both inside and outside of the catchment area):
Inside catchment area

Outside catchment area
Hospital laboratories
Dialysis referral laboratories
Commercial/outpatient laboratories*
Other; please specify:_______________________________
Total number (Add above together)

*For the purpose of the survey, we are defining “Commercial/Outpatient Laboratories” as any for profit laboratory, not including dialysis referral
laboratories, that serve health care facilities in a given surveillance catchment area. Examples include LabCorp and Quest.

3. Please indicate the culture sources your site requests from participating labs for surveillance other
than blood, CSF, pleural fluid, peritoneal fluid, pericardial fluid, joint/synovial fluid, bone, and
muscle?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
4. Indicate the percentage contribution of each case finding method to your site’s total SA case counts
(100%) in 2017.
Case Finding
% MSSA
% MRSA
Method
Method Used? Case Count
Case Count
Contribution
Contribution
Y
N
NETSS/NEDSS or other passive state reporting system
Y
N
Retrospective review of received line lists from hospital labs
Y
N
Routinely received line lists from commercial/outpatient labs
Y
N
Routinely received line lists from dialysis referral labs
Y
N
Regular lab visits; frequency:_______________
Y
N
ICPs submitting case report form
Y
N
Isolates being received at state lab
Y
N
NHSN
Y
N
Other, please specify______________________________

a. Do you expect this distribution and/or percentage values to change in 2017?
_______ yes
_______ no
i. If yes, please explain why:
________________________________________________________________________
________________________________________________________________________
5. For labs reporting invasive SA, how many of the participating labs are providing case reports
through direct electronic messaging, such as HL7 messaging? ________
a. If less <100%, how else are you receiving reports?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
b. What are the perceived barriers to use of direct electronic messaging?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
b. How important is electronic messaging for your site? (1-- not important at all; 5--very high
priority)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
6. Did any labs drop out of participation in 2017?
_______ yes
_______ no
a. If yes, how many? _______
b. Why did these labs drop out of participation?
__________________________________________________________________
__________________________________________________________________
7. In 2017, did you identify any additional labs, regardless of location, which identify invasive SA
isolates from persons who are residents of your catchment area?
_______ yes
_______ no
a. If yes, how did you find these labs?
______________________________________________________________________
b. If yes, how many labs did you find? _________
c. If yes, how many of these labs were added? _______
i. If not all found labs were added, why
not?______________________________________________________________
__________________________________________________________________
d. Approximately how many cases does this/these lab(s) identify each year among residents
of your catchment area? _______

Data Edits
1. Does your site run a data edit program in addition to the CDC edit program that is sent out
monthly?
_______ yes
_______ no
a. If yes, how often:
_______ Monthly
_______ Quarterly
_______ Other time frame, specify: ______________________________________
_______ Never
b. If yes, what types of edits are you running? Do you think they would be helpful to add to
CDC’s edit process?
______________________________________________________________________________
______________________________________________________________________________

Ascertainment of Surveillance Area* and Case Audits*
*“Case ascertainment” should include ongoing attempts to identify new or additional laboratories inside and outside of your defined catchment area which
may be processing MRSA specimens for surveillance area residents.
*Audits of all laboratories both within the ABCs MRSA surveillance area and those outside are required once a year. The purpose of the audit is to ensure
that all cases of invasive MRSA are being captured. The primary data source at every reporting laboratory (e.g. laboratory log slips/log book, computergenerated electronic printouts, case reports, line lists) should be reviewed for invasive MRSA cases and compared to the list of cases that were reported to
the surveillance personnel.

1. How did your site define an audit case in 2017?
_________________________________________________________________________________
_________________________________________________________________________________
2. Indicate the percentage contribution of each case finding method to your site’s audit counts (100%)
in 2017.
Audit Method % MSSA
% MRSA
Method
Used?
Audit Count
Audit Count
Contribution
Contribution
Y
N
NETSS/NEDSS or other passive state reporting system
Y
N
Retrospective review of received line lists from hospital labs
Y
N
Routinely received line lists from commercial/outpatient labs
Y
N
Routinely received line lists from dialysis referral labs
Y
N
Regular lab visits; frequency:_______________
Y
N
ICPs submitting case report form
Y
N
Isolates being received at state lab
Y
N
NHSN comparison
Y
N
Other, please specify______________________________

3. Does your site assess your individual laboratory case auditing* methods?
*Audits of all laboratories both within the HAIC MRSA surveillance area and those outside are required once a year. The purpose of the audit is
to ensure that all cases of invasive MRSA are being captured. The primary data source at every reporting laboratory (e.g. laboratory log
slips/log book, computer-generated electronic printouts, case reports, line lists) should be reviewed for invasive MRSA cases and compared to
the list of cases that were reported to the surveillance personnel.

_______ yes

_______ no

a. If no, please explain why:
___________________________________________________________________________
___________________________________________________________________________

b. If yes, how often is this performed? When was this last performed?
___________________________________________________________________________
___________________________________________________________________________
c. If yes, how does your site perform audits*?
_______ Remove negative restrictions from line list reports
_______ Review actual query codes
_______ Review selection criteria
_______ Other, please specify_______________________________________________
i.

If you picked “Review actual query codes”, can you see pathogen resistance
information? For example, in the query code can you see that the laboratory is
including isolates resistant to oxacillin for MRSA?
_____Yes
_____No

4. Does your site perform routine ascertainment* of the surveillance area?
*“Case ascertainment” should include ongoing attempts to identify new or additional laboratories inside and outside of your defined catchment
area which may be processing specimens for surveillance area residents.

_______ yes

_______ no

a. If yes, how does your site assess case ascertainment* methods?
(examples include: physician surveys, LTCF surveys, outreach to new dialysis centers, etc…).

________________________________________________________________________
________________________________________________________________________
b. If yes, how often is this performed? When was this last performed?
________________________________________________________________________
________________________________________________________________________
5. Are there specific labs that you have difficulty obtaining line lists from?
_______ yes
_______ no
a. If yes, what types of labs? ______________________________________________________
______________________________________________________________________________

6. Does your site have checks in place to recognize decreasing/increasing case counts or rates of
MRSA disease?
_______ yes
_______ no
a. If yes, please describe the check(s) that you use____________________________________
____________________________________________________________________________
b. If yes, how often are the check(s) used? _______________________________________
c. If yes, do you plan to use these for MSSA once more surveillance data are available?
_______ yes
_______ no

Geocoding
1. Is your site continuing to geocode SA cases?
_______ yes
_______ no

CDC Responsibilities
1. CDC staff are responsive to questions/concerns/emails (e.g., Valerie Albrecht, Kelly Jackson, Isaac
See, and Shirley Zhang).
_______ Strongly agree
_______ Agree
_______ Neutral
_______ Disagree
_______ Strongly disagree
a. If you disagree or strongly disagree, please explain and provide improvement suggestions:
______________________________________________________________________________
______________________________________________________________________________
2. Monthly surveillance officer calls are a valuable use of my time.
_______ Strongly agree
_______ Agree
_______ Neutral
_______ Disagree
_______ Strongly disagree
a. If you disagree or strongly disagree, please explain and provide improvement suggestions:
______________________________________________________________________________
______________________________________________________________________________
3. What parts of the SA SharePoint site do you use the least or find the least useful?
_________________________________________________________________________________
_________________________________________________________________________________
4. Can you suggest any future training topics that might be useful for SA surveillance officers?
______________________________________________________________________________
______________________________________________________________________________

5. What SA topics would you like to see covered at the HAIC Surveillance Officer’s Meeting during
the SA session next year?
______________________________________________________________________________
______________________________________________________________________________

END
Thank you very much!