Health Information Portal (HIP)

Pandrug-resistant Organisms (PDRO)

Topic	Priority Priority Alert Conveys the highest level of importance; warrants immediate action or attention. Advisory Provides important information for a specific incident or situation; may not require immediate action. Notification Provides information regarding an incident or situation; unlikely to require immediate action. Update Provides updated information regarding an incident or situation; unlikely to require immediate action.	Date of Alert
Call for Cases: Multistate Cluster of Extensively Drug-Resistant Acinetobacter baumannii and Enterobacter cloacae complex	Advisory	Dec 9, 2025

Surveillance

Surveillance

• Case Definition: A culture yielding a bacterium or fungus (colonization or infection) that exhibits non-susceptibility to ALL antibacterial or ALL anti-fungal agents tested through routine antimicrobial susceptibility testing (AST) assays (i.e., all drugs tested for susceptibility are either intermediate or resistant).

Vaccine Information

There is no vaccine information available for Pandrug-resistant Organisms (PDRO).

Diagnosis & Management

Diagnostics and Treatment

• PDRO infection is diagnosed through a culture from the affected body site. By definition, PDRO infections are resistant to most commonly used antimicrobial drugs and treatment options may be limited. Providers should order AST to determine the appropriate drug for treatment.
• PDPH can coordinate testing for some novel drugs that are not yet commercially available through the Antibiotic Resistance Lab Network (ARLN). Please email the HAI/AR team at HAI.PDPH@Phila.gov or call at (215) 685-4501 for details.
• CDC does not recommend treatment of PDROs identified from noninvasive sites (such as upper respiratory tract, urine, and skin colonization) when there is no evidence of infection.
• Isolates should be retained for one month. PDPH will follow up to coordinate further testing as needed.

Guidelines for Management and Control

CDC Guidelines:

• Implementation of Personal Protective Equipment (PPE) in Nursing Homes to Prevent Spread of Novel or Targeted Multidrug-resistant Organisms (MDROs)

Hospitalized Patients:

• PDRO patients shall be placed on contact precautions and in a private room for the duration of all current and future healthcare stays.
• Because patients may remain colonized for more than one year, do not discontinue precautions when the infection clears.
• There is not enough evidence to make a firm recommendation about when to discontinue use of Contact Precautions for infected or colonized patients.
• Prior to patient transfer, the transferring facility should notify the receiving facility of the PDRO colonization or infection.

Long Term Care Facilities Residents:

• PDRO patients shall be placed on contact precautions or enhanced barrier precautions and placed in a private room, if available, for the duration of all current and future healthcare stays.
• If PDRO patients cannot be placed in a private room, in room isolation precautions should be implemented.
• Because patients may remain colonized for more than one year, do not discontinue precautions when the infection clears, or antibiotic course is completed.
• Prior to patient transfer, the transferring facility should notify the receiving facility of the PDRO colonization or infection.

Disinfection Guidance:

• Equipment should be dedicated to the colonized or infected patient whenever possible.
  • Shared medical equipment should be disinfected immediately after use. 
• Daily disinfection, with products appropriate for the identified PDRO, that includes areas in close proximity to the patient, high-touch surfaces in the room, as well as surfaces around sinks and toilets.
• Immediate cleaning and disinfection of equipment or surfaces contaminated with blood, serum, urine, purulent discharges, feces, and other bodily fluids or infectious materials.
• Terminal cleaning shall consist of thorough wet cleaning and disinfection. Specific products should be utilized based on the identified organism. 

Resources

For Healthcare Providers:

Reporting to PDPH

• Report PDRO cases (colonization or infection) within 24 hours by calling 215-685-6748 [after business hours (215) 685-4514].  Complete a PDRO case report form after reporting the case via phone. Completed forms can be faxed to (215) 238-6947.
• PDPH Pandrug-Resistant Organism Report Form
• Drug Resistant Organism Reporting Requirements: Frequently Asked Questions [PDPH, 2018]

Links and Resources

• PDPH PDRO Line List
• PDPH Inter-Facility Transfer Form
• CDC Threat Report: Antibiotic Resistance threats in the United States [CDC, 2019]
• Information for Facilities: CRAB Carbapenem-resistant Acinetobacter baumannii [CDC, 2023]
• Information for Facilities: CRPA Carbapenem-resistant Pseudomonas aeruginosa [CDC, 2023]

For Patients and Community Members:

Posters:

There are no posters for Pandrug-resistant Organisms (PDRO).