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Multi-Site Gram-negative Surveillance Initiative (MUGSI)


MUGSIGram-negative bacilli commonly cause infections in both health care and community settings. Emergence of resistance of these organisms to several antibiotics, such as carbapenems, makes treatment of these organisms more challenging. Examples of gram-negative bacilli include E. coli and K. pneumoniae. To monitor trends in the incidence of carbapenem resistant Enterobacteriaceae (“CRE”) and Extended-Spectrum β-Lactamases (ESBLs) Enterobacteriaceae, we conduct population-based surveillance among residents of Monroe County, NY, as part of the Centers for Disease Control and Prevention (CDC) Emerging Infections Program MUGSI initiative

Goals and Objectives

  • Determine the extent of CRE, carbapenem-resistant Acinetobacter and ESBLs disease in Monroe County
  • Identify people most at risk for illness from these organisms
  • Measure trends of disease over time
  • Describe the epidemiology of bloodstream and urinary tract infections caused by E.coli to identify priority areas for future surveillance, public health interventions and vaccine development


Working with laboratories in Monroe County, the surveillance team identifies carbapenem resistant organisms, as well as those resistant to third generation cephalosporins. Demographic data and potential risk factors for infection and prior exposure to health care are collected. Selected isolates are sent to the CDC for further study.

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Extended-Spectrum Beta-Lactamase Enterobacterales Surveillance, Monroe County, NY, 2020-2022