Form I18 Healthcare Wasterwater-based Surveillance

Form Approved

OMB Control No.: 0920-1310

Expiration date: XX/XX/XXXX

Annual Evaluation and Performance Measurement Report (I.18- HEALTHCARE WASTEWATER-BASED SURVEILLANCE)

Annually, each funded laboratory is required to report to CDC evaluation and performance measures. Data are used to indicate progress made toward program outcomes. These summary reports have to be uploaded to the ELC CAMP at the end of each funding year. Required performance measures are listed below.

1. Describe how potential collaborations with LTACH and SNF facilities were sought and feedback from facilities about the feasibility of participating.

2. Proportion of point prevalence screening (PPS)/colonization screening swabs tested for (i) Candida auris and (ii) carbapenemase genes (blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48)

a. Numerator: Number of PPS/colonization screening swabs tested for Candida auris and carbapenemase genes (blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48)

b. Denominator: Total number of PPS/colonization screening swabs collected.

c. Calculated: Percent of swabs tested for Candida auris and carbapenemase genes (blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48).

3. Proportion of wastewater samples tested for (i) Candida auris and (ii) carbapenemase genes (blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48):

a. Numerator: Number of wastewater samples tested for Candida auris and carbapenemase genes (blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48).

b. Denominator: Total number of wastewater samples collected.

c. Calculated: Percent of wastewater samples tested for Candida auris and carbapenemase genes (blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48)

4. Proportion of wastewater samples aligned with PPS/colonization screening swabs for (i) C. auris and/or (ii) carbapenemase genes (blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48):

a. Numerator: Number of wastewater samples collected on the same day as PPS swabs.

b. Denominator: Total number of PPS/colonization screening swabs collected for (i) C. auris and/or (ii) carbapenemase genes (blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48)

c. Calculated: Percentage of wastewater samples collected on the same day (matched samples) as PPS/colonization screening swabs collected for (i) C. auris and/or (ii) carbapenemase genes (blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-48)

5. Describe challenges to collect and analyze wastewater and swabs

6. Considering coordination and information sharing among PHL and wastewater (WW) stakeholders: 

1. How often do you meet with relevant wastewater stakeholders?  

• Daily  

• Weekly  

• Bi-Weekly  

• Monthly  

• Quarterly  

• Annually  

2. Describe the information shared between partners.

3. What strategies work well to maintain coordination and sharing?  

4. What challenges do you encounter with advancing coordination and collaboration? 

Public reporting burden of this collection of information is estimated to average 20 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 currently 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 Road NE, MS H21-8, Atlanta, Georgia 30333; ATTN: PRA 0920-1310