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South Dakota Department of Health
South Dakota Department of Health

Disease Prevention Services

Carbapenemase-producing Organism (CPO)

In January 2024, the South Dakota Department of Health officially changed the surveillance case definition from Carbapenem-Resistant Enterobacteriaceae (CRE) to Carbapenemase-producing organism (CPO)  to stay in alignment with national surveillance efforts. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Clinical diagnosis and infection prevention standards remain the same despite the case definition name.  

CPO, CRE, and CRO are significant public health concerns and contribute to the growing problem of antibiotic resistance. The Enterobacterales constitute a large order of Gram-negative bacilli, many of which are normal inhabitants of the intestinal tract in humans, other mammals, and birds. Enterobacterales most encountered in healthcare settings include the genera Citrobacter, Enterobacter, Escherichia, Klebsiella, Morganella, Proteus, Providencia, and Serratia. Other frequently encountered carbapenem-resistant Gram-negative organisms (not in the order, Enterobacterales) include Acinetobacter and Pseudomonas.

Carbapenem antibiotics (ertapenem, imipenem, meropenem, and doripenem) are broad-spectrum (active against many different groups of bacteria) and are usually reserved for severe life-threatening infections. Certain Gram-negative bacilli, including the Enterobacterales, Pseudomonas, and Acinetobacter, have developed carbapenem resistance, which limits options for treating infections due to these organisms. The mechanism of resistance can be varied; most concerning are carbapenemases, enzymes produced by bacteria that directly inactivate carbapenems. Carbapenemase genes can be transmitted on plasmids. This "horizontal inheritance" is primarily responsible for the worldwide spread of carbapenemase-producing organisms (CPO). 

For details, see the CDC website.

CRE is a reportable condition in South Dakota

South Dakota CPO Resources