NHSN Logo Lab-identified Organism (LIO) Report

Patient Ned Nuclear
Admission Date January 15, 2009
Date of birth November 25, 1954 Sex Male
Race White Ethnicity Not Hispanic or Latino
Contact info address not available
Telecom information not available
Patient IDs 123456 (2.16.840.1.113883.3.117.1.1.5.1.1.1)
Document Id 20202201 (2.16.840.1.113883.3.117.1.1.5.2.1.1.2)
Document Created August 7, 2008
Author anAuthorID (2.16.840.1.113883.3.117.1.1.5.1.1.2)
Encounter Date  From January 15, 2009
Encounter Location 2.16.840.1.113883.3.117.1.1.5.1.1
Document maintained by 2.16.840.1.114222.4.3.2.11
Legal authenticator aLegalAuthenticatorID (2.16.840.1.113883.3.117.1.1.5.1.1.2)
signed date/time: August 7, 2008

Table of Contents


Encounters

Prior Discharge from this Facility (past 4 wks) December 5, 2008
Discharged from another facility (past 4 wks) Yes
Other facility encounter type: inpatient encounter Other facility: Nursing Home/Skilled Nursing Facility
Other facility encounter type: inpatient encounter Other facility: Other Inpatient Healthcare Setting (e.g., Acute Care Hospital, LTAC, Rehabilitation, etc.)

Lab-identified organism

Microorganism Identified CRE-Klebsiella (CREKLEB)
Specimen type Pericardial fluid specimen (specimen)
Date specimen collected January 21, 2009
Procedure date January 21, 2009
In-facility location where patient was when specimen was drawn 9W Medical-Surgical Critical Care
Date admitted/transferred to the location where the specimen was drawn January 17, 2009
Bacterial isolate tested for carbapenemase Yes
Carbapenemase Test Performed (PCR-KPC) Polymerase chain reaction – Klebsiella pneumoniae carbapenemase
Carbapenemase Test Performed (MBLs) Metallo-β-lactamase screen
Carbapenemase Test Performed Other : Other carbapenemase test not in value set
Isolate tested positive for carbapenemase Yes
Carbapenemase Type Identified (IMP) Imipenemase
Carbapenemase Type Identified Other : Other carbapenemase type not in value set

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