Impact of different carbapenemase-producing Enterobacterales screening strategies in a hospital setting.
Infect Prev Pract
; 2(3): 100011, 2020 Sep.
Article
in En
| MEDLINE
| ID: mdl-34368706
ABSTRACT
BACKGROUND:
The spread of carbapenemase-producing Enterobacterales (CPE) is a global health problem. Gastrointestinal tract carriage makes faeces or rectal swabs the recommended screening methods.AIM:
To assess the impact of three laboratory screening strategies for CPE on positivity rates and infection prevention and control in a hospital setting in North West England from 2015 to 2017.METHODS:
In a retrospective study, time to CPE-positive and -negative results, number of new CPE-positive patients identified, and number of hospital bed-days lost/wards affected were measured for each of three CPE screening strategies; culture plus phenotypic tests, culture plus polymerase chain reaction (PCR), and PCR only (phases 1, 2 and 3, respectively).FINDINGS:
The fastest time to CPE results was PCR only (median 4.0 h), then culture plus PCR (median 47.6 h), then culture plus phenotypic tests (median 49.8 h) (P < 0.001). The mean numbers of hospital bed-days lost per month decreased between phases 2 and 3 (P = 0.01). The mean number of wards/units affected by CPE increased from phase 1 (2.57) to phase 2 (7.71), then decreased in phase 3 (3.86). The percentage positivity rate for phases 1, 2, and 3 were 2.01, 1.38, and 1.55 respectively. From May to October, the number of new CPE-positive patients was lower for phases 1 and 3 than for phase 2. During all three phases there was a peak in the number of newly identified CPE carriers in August.CONCLUSION:
This study provides evidence that using a rapid PCR to screen rectal or faeces swabs enables more timely infection prevention and control measures when compared with culture-based methods. A reduction in bed-days lost due to CPE was observed when rapid molecular screening was introduced.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Screening_studies
Language:
En
Journal:
Infect Prev Pract
Year:
2020
Document type:
Article
Affiliation country:
United kingdom