Multi-Drug Resistant Gram Negative Bacilli (MUGSI) Surveillance Purpose To conduct population based surveillance for Multi-Drug Resistant Gram Negative Bacilli (MuGSI) of residents of Monroe County, NY in order to estimate the burden of disease and observe any increase in incidence. Goals and Objectives To evaluate the population-based incidence of carbapenem-nonsusceptibility among common strains of Enterobacteriaceae and Acinetobacter species and describe how the incidence changes over time To better characterize carbapenem-nonsusceptible strains in sites submitting data in order to inform prevention efforts To describe known resistance mechanisms among a subset of carbapenem-nonsusceptible Enterobacteriaceae Activities Working with laboratories in Monroe County, the surveillance team will identify carbapenem resistant organisms, as well as those resistant to third generation cephalosporins. Case-patients infections will be characterized as hospital-onset, healthcare-associated community onset, or community-associated. Selected isolates will be sent to the Centers for Disease Control and Prevention (CDC) for further study. Demographic data, as well as data about the nature of the identified bacterial culture will be collected on a case report form and entered into a database for submission to the CDC. Our surveillance will contribute to the surveillance of over 12 million people performed by epidemiologists in Colorado, Georgia, Maryland, Minnesota and Oregon.