Invasive Staph aureus Lab Survey

CDC’s Healthcare-Associated Infections Community Interface (HAIC) Staphylococcus
aureus Laboratory Survey: Use of Nucleic Acid Amplification Testing (NAAT)

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

Date Survey Completed: _________________ EIP Site: __________ Completed by: ______________________________
Hospital/Lab ID: ________________________ Lab contact to complete the survey (name/title): ______________________

□ Lab did not respond – END SURVEY
1. Type of laboratory

□ Hospital laboratory
□ Commercial or private reference laboratory
□ State or local public health laboratory
□ Other, please specify______________________________________________________________________

2. During the past year, has your lab changed testing methods used to detect any of the following pathogens:

MRSA only
All Staphylococcus aureus

Yes

No

□
□

□
□

Not applicable/
no surveillance

□
□

2a. If yes when did the change occur?
MRSA (i.e., not for MSSA) (Month/year of change) _______/_________
Staphylococcus aureus (i.e., both MRSA and MSSA) (Month/year of change) _______/____________

Staphylococcus aureus (methicillin-sensitive and methicillin-resistant)
1. Do you routinely set up culture for sterile sites (blood, CSF, bone, etc.) on site (in-house) at your
laboratory?

□ Yes

- GO TO Q2

□ No – GO TO Q3

1a. [If no] To which laboratory do you send sterile specimens for culture/identification?

____________________________________
2. Is S. aureus or MRSA routinely identified via culture-based methods on site (in-house) at your laboratory?

□ Yes

- GO TO Q3

□ No

2a. [If no] To which laboratory do you send cultures for S. aureus identification?

____________________________________
3. Do you routinely run any culture independent diagnostic tests (CIDT) on site or at another lab for detection
of S. aureus or MRSA either directly from a sterile source (CSF, Blood, etc.) or from a positive blood
culture?

□ Yes

□ No - GO TO Q3d

3a. [If yes] Where is CIDT testing completed?
□ On-site
□ Send out, please specify lab __________________ - GO TO Q3c
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ATTN: PRA (xxxx-xxxx)

–IMPORTANT – PLEASE COMPLETE THE BACK OF THIS FORM –

3b. Which CIDTs do you use (sterile site sources only, i.e. blood, CSF, pleural fluid, bone, etc.)? Please
check all that apply.

□ FilmArray® Blood Culture Identification Panel..Date started__________
□ Verigene® Gram-Positive Blood Culture Test…Date started__________
□ Verigene® Staphylococcus Blood Culture Test…Date started__________
□ Cepheid Xpert® MRSA/SA BC…Date started__________
□ BD Geneohm® StaphSR…Date started__________
□ AdvanDx Staphylococcus QuickFISH blood culture kit…Date started__________
□ AdvanDx S. aureus/CNS PNA FISH…Date started__________
□ Alere BinaxNOW® Staphylococcus aureus test…Date started__________
□ Great Basin Staph ID/R blood culture panel…Date started__________
□ T2Bacteria® Panel…Date started__________
□ Accelerate PhenoTest™ BC kit…Date started ________________
□ iCubate iC-GPC Assay™…Date started ________________
□ mecA XpressFISH® …Date started ________________
□ Micacom hemoFISH Masterpanel … Date started ________________
□ ePlex BCID-GP Panel … Date started ________________
□ Other, Lab Developed Test (detects MRSA or SA)… Date started ____________________
□ Other commercial test, Specify_______...Date started__________
3c. [If using any of the above tests on sterile site specimens] Do you still obtain an isolate for S.
aureus or MRSA?
□ Yes

□ No - GO to Q4

3d. [If no] Do you plan to start offering any CIDTs for S. aureus or MRSA within the next year?

□ Yes

□ No – END SURVEY

3e. When do you plan to start offering CIDTs?
Month/Year: ____/____

3f. Where do you plan to have CIDT tested?
□ On-site

□ Send out, please specify lab __________________ - END SURVEY

4. How does your lab use the CIDT for detection of S. aureus or MRSA? (select one)

□ Test concurrently with culture
□ Reflex to culture after positive by CIDT panel
□ Only run CIDT panel, no additional testing is done
□ Other, specify _____________

Comments:

END SURVEY