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Isolation demand from carbapenemase-producing Enterobacteriaceae screening strategies based on a West London hospital network.
- Source :
- Journal of Hospital Infection; Oct2016, Vol. 94 Issue 2, p118-124, 7p
- Publication Year :
- 2016
-
Abstract
- <bold>Objective: </bold>To estimate the isolation demands arising from high-risk specialty-based screening for carbapenemase-producing Enterobacteriaceae (CPE), and the potential fraction of CPE burden detected.<bold>Methods: </bold>Clinical specialty groups from three London hospitals were ranked by incidence of carbapenem resistance among Escherichia coli and Klebsiella spp. Contact precaution bed-days were estimated for three screening strategies: Strategy 1, 'circulation science and renal medicine'; Strategy 2, Strategy 1 plus 'specialist services'; and Strategy 3, Strategy 2 plus 'private patients'. Isolation bed occupancy rates and potential CPE detection rates were estimated.<bold>Results: </bold>Of 99,105 admissions to the three hospitals in Financial Year 2014/15, Strategies 1, 2 and 3 would have screened 4371 (4.4%), 7482 (7.6%), and 13,542 (13.7%) patients, respectively. The specialties' isolation bed occupancy rates varied between 3% and 696% depending on strategy, number of consecutive tests, and whether or not pre-emptive isolation had been applied. Expected detection rates of the potential CPE burden in the hospital network would have varied between 17.1% and 47.5%.<bold>Conclusions: </bold>High-risk specialty-based screening has the potential to detect nearly half of the potential CPE burden, and would be more pragmatic than patient-level risk-factor-based screening. Pre-emptive isolation increases isolation requirements substantially. CPE screening strategies need to balance risk and resources. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 01956701
- Volume :
- 94
- Issue :
- 2
- Database :
- Supplemental Index
- Journal :
- Journal of Hospital Infection
- Publication Type :
- Academic Journal
- Accession number :
- 118101639
- Full Text :
- https://doi.org/10.1016/j.jhin.2016.04.011