healthcare-associated infections (hai) program

Antimicrobial Resistance

More than 2.8 million illnesses and 35,000 deaths are attributed to infections with antimicrobial-resistant organisms in the United States each year. Among Californians, this translates to roughly 360,000 illnesses and nearly 4,500 deaths.
The Centers for Disease Control and Prevention (CDC) Antibiotic Resistance (AR) Threats in the United States, 2019 Report (PDF) includes carbapenem-resistant Enterobacterales (CRE) and Acinetobacter, Candida auris (C. auris), Clostridioides difficile (C. difficile), and multidrug-resistant Pseudomonas aeruginosa as urgent and serious threats.
The U.S. Department of Health and Human Services National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB), 2020-2025 (PDF) outlines a coordinated plan to respond to these AR threats.

Key measures and actions to address AR in CA; cycle repeats 1. Preventing emergence 2. Detection 3. Containment

1. Preventing Emergence
HAI Honor Roll Medals logo

Core actions to prevent resistance include improving antimicrobial prescribing through stewardship, reducing infections, and preventing transmission of antimicrobial-resistant bacteria.

Antimicrobial Stewardship Program Honor Roll

2. Detection
Petri Dish with Bacteria

CDPH connects clinicians, infection preventionists, laboratorians, and public health practitioners to testing resources for the rapid detection of antimicrobial-resistant pathogens.

California Antimicrobial Resistance Lab-Epi Alliance

3. Containment
ASP Containment logo

CDPH utilizes a systematic framework for containing spread of antimicrobial-resistant pathogens.
California Antimicrobial-Resistant Pathogen Containment Plan (coming soon)
California Antimicrobial-Resistant Pathogen Containment Plan Tiers (PDF)
Tier 2 Pathogen Screening Decision Tree (PDF)
Algorithm for Prioritizing Carbapenemase Testing (PDF)

Pathogens

	Candida auris (C. auris) C. auris Quicksheet (PDF) C. auris Quicksheet printable version (PDF) California Antimicrobial-Resistant Pathogen Containment Plan Tiers (PDF) Tier 2 Pathogen Screening Decision Tree (PDF) Regional C. auris Phased Prevention and Response Strategy (PDF) C. auris Information for Patients and Families webpage
	Carbapenem-resistant Acinetobacter (CRAB) CRPA and CRAB Quicksheet (PDF) California Antimicrobial-Resistant Pathogen Containment Plan Tiers (PDF) Tier 2 Pathogen Screening Decision Tree (PDF) Algorithm for Prioritizing Carbapenemase Testing (PDF) CRAB Information for Patients and Families
	Carbapenem-resistant Enterobacterales (CRE) CRE Quicksheet (PDF) Carbapenemase-producing Organisms (CPO) FAQ (PDF) California Antimicrobial-Resistant Pathogen Containment Plan Tiers (PDF) Tier 2 Pathogen Screening Decision Tree (PDF) Algorithm for Prioritizing Carbapenemase Testing (PDF) CRE Information for Patients and Families
	Carbapenem-resistant Pseudomonas aeruginosa (CRPA) CRPA and CRAB Quicksheet (PDF) California Antimicrobial-Resistant Pathogen Containment Plan Tiers (PDF) Tier 2 Pathogen Screening Decision Tree (PDF) Algorithm for Prioritizing Carbapenemase Testing (PDF) CRPA Information for Patients and Families
	Clostridioides difficile (C. difficile) C. difficile Quicksheet (PDF)