Pilot Testing of an Out-of-Country Medical Care Questionnaire with Screening and Cost Analysis of Preemptive Isolation for Carbapenem-Resistant Enterobacteriaceae in a Large Canadian Health Region

Rajapakse, Nipunie; Vayalumkal, Joseph; Lam-Li, Debbie; Pearce, Craig; Rees, Gwynne; Kamhuka, Linda; Peirano, Gisele; Pidhorney, Corrinne; Ledgerwood, Donna; Alfieri, Nancy; Hope, Karen; Gregson, Dan; Pitout, Johann; Louie, Thomas; Conly, John

doi:10.1086/675616

Cited by 5 publications

(4 citation statements)

References 6 publications

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“…Added to the cost of screening is the cost of isolation. A 2014 Canadian study estimated a cost of Can$925 (approximately US$740) per non-ICU patient when a patient is isolated for 3 days while awaiting results (137).…”

Section: Screening Methods To Detect Fecal Carriage Of Cposmentioning

confidence: 99%

Intestinal Carriage of Carbapenemase-Producing Organisms: Current Status of Surveillance Methods

et al. 2016

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SUMMARYCarbapenemases have become a significant mechanism for broad-spectrum β-lactam resistance inEnterobacteriaceaeand other Gram-negative bacteria such asPseudomonasandAcinetobacterspp. Intestinal carriage of carbapenemase-producing organisms (CPOs) is an important source of transmission. Isolation of carriers is one strategy that can be used to limit the spread of these bacteria. In this review, we critically examine the clinical performance, advantages, and disadvantages of methods available for the detection of intestinal carriage of CPOs. Culture-based methods (Centers for Disease Control and Prevention [CDC] protocols, chromogenic media, specialized agars, and double-disk synergy tests) for detecting carriage of CPOs are convenient due to their ready availability and low cost, but their limited sensitivity and long turnaround time may not always be optimal for infection control practices. Contemporary nucleic acid amplification techniques (NAATs) such as real-time PCR, hybridization assays, loop-mediated isothermal amplification (LAMP), or a combined culture and NAAT approach may provide fast results and/or added sensitivity and specificity compared with culture-based methods. Infection control practitioners and clinical microbiologists should be aware of the strengths and limitations of available methods to determine the most suitable approach for their medical facility to fit their infection control needs.

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Section: Screening Methods To Detect Fecal Carriage Of Cposmentioning

confidence: 99%

Intestinal Carriage of Carbapenemase-Producing Organisms: Current Status of Surveillance Methods

et al. 2016

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“…They also tend to be significantly more expensive than culture-based systems [ 47 ]. Nevertheless, in this context, we emphasize that the longer TAT of culture-based methods may actually imply higher overall healthcare costs (e.g., for unnecessarily preemptive isolation for non-colonized patients) [ 48 ].…”

Section: Screening Of Carriersmentioning

confidence: 99%

Intestinal colonization with multidrug-resistant Enterobacterales: screening, epidemiology, clinical impact, and strategies to decolonize carriers

Campos-Madueno

Moradi

Eddoubaji

et al. 2023

Eur J Clin Microbiol Infect Dis

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The clinical impact of infections due to extended-spectrum β-lactamase (ESBL)- and/or carbapenemase-producing Enterobacterales (Ent) has reached dramatic levels worldwide. Infections due to these multidrug-resistant (MDR) pathogens—especially Escherichia coli and Klebsiella pneumoniae—may originate from a prior asymptomatic intestinal colonization that could also favor transmission to other subjects. It is therefore desirable that gut carriers are rapidly identified to try preventing both the occurrence of serious endogenous infections and potential transmission. Together with the infection prevention and control countermeasures, any strategy capable of effectively eradicating the MDR-Ent from the intestinal tract would be desirable. In this narrative review, we present a summary of the different aspects linked to the intestinal colonization due to MDR-Ent. In particular, culture- and molecular-based screening techniques to identify carriers, data on prevalence and risk factors in different populations, clinical impact, length of colonization, and contribution to transmission in various settings will be overviewed. We will also discuss the standard strategies (selective digestive decontamination, fecal microbiota transplant) and those still in development (bacteriophages, probiotics, microcins, and CRISPR-Cas-based) that might be used to decolonize MDR-Ent carriers.

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“…Entretanto, um estudo canadense que realizou análise semelhante à do presente trabalho identificou que o maior tempo necessário a para emissão de resultado do método baseado em culturas significa que um paciente pode ser colocado desnecessariamente em isolamento preventivo por três dias ou mais, como argumentado neste trabalho, o que se estima que custará US$ 925 a mais por paciente no Canadá, ou cerca de R$ 3.145 em conversão livre direta, considerando-se o dólar igual a R$ 3,4 (Rajapakse et al, 2014).…”

Section: Discussionunclassified

Custo-efetividade de teste rápido de detecção de Klebsiella spp. para rastreio hospitalar

Rocha¹,

Rocha²,

Alcantara³

et al. 2019

JBES

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Pilot Testing of an Out-of-Country Medical Care Questionnaire with Screening and Cost Analysis of Preemptive Isolation for Carbapenem-Resistant Enterobacteriaceae in a Large Canadian Health Region

Cited by 5 publications

References 6 publications

Intestinal Carriage of Carbapenemase-Producing Organisms: Current Status of Surveillance Methods

Intestinal Carriage of Carbapenemase-Producing Organisms: Current Status of Surveillance Methods

Intestinal colonization with multidrug-resistant Enterobacterales: screening, epidemiology, clinical impact, and strategies to decolonize carriers

Custo-efetividade de teste rápido de detecção de Klebsiella spp. para rastreio hospitalar

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