Screening for carbapenemase-producing enterobacteriaceae following transmission: Experience at a large victorian healthcare facility

Spilsbury, Stephanie; Rosario-Kelly, Denise Del; Borrell, Sue; Bass, Pauline; McLellan, Sue; Stewardson, Andrew J.; Cheng, Allen; Worth, Leon J

doi:10.1016/j.idh.2018.09.044

Cited by 2 publications

(1 citation statement)

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“…Testing for CPE infection is based on highly varied screening procedures, with increased screening being performed generally in intensive care units, and after an outbreak is detected [20]. As a result, it is unlikely that detection of CPE infection is perfect.…”

Section: Discussionmentioning

confidence: 99%

Carbapenemase-producing Enterobacterales colonisation status does not lead to more frequent admissions: a linked patient study

Lydeamore,

Donker,

et al. 2024

Preprint

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Background. Hospitals in any given region can be considered as part of a network, where facilities are connected to one another - and hospital pathogens potentially spread - through the movement of patients between them. We sought to describe the hospital admission patterns of patients known to be colonised with carbapenemase-producing Enterobacterales (CPE), and compare them with CPE-negative patients. Methods. We performed a linkage study in Victoria, Australia, including datasets with notifiable diseases (CPE notifications) and hospital admissions (admission dates and diagnostic codes) for the period 2011 to 2020. Where the CPE notification date occurred during a hospital admission for the same patient, we identified this as the 'index admission'. We determined the number of distinct health services each patient was admitted to, and time to first admission to a different health service. We compared CPE-positive patients with four cohorts of CPE-negative patients, sampled based on different matching criteria. Results. Of 528 unique patients who had CPE detected during a hospital admission, 222 (42%) were subsequently admitted to a different health service during the study period. Among these patients, CPE diagnosis tended to occur during admission to a metropolitan public hospital (86%, 190/222), whereas there was a greater number of metropolitan private (23%, 52/222) and regional public (18%, 39/222) hospitals for the subsequent admission. Median time to next admission was 4 days (IQR, 0-75 days). Admission patterns for CPE-positive patients was similar to the cohort of CPE-negative patients matched on index admission, time period, and age-adjusted Charlson comorbidity index. Conclusions. Movement of CPE-positive patients between health services is not a rare event. While the most common movement is from one public metropolitan health service to another, there is also a trend for movement from metropolitan public hospitals into private and regional hospitals. CPE-positivity does not appear to impact on hospital admission frequency and timing. These findings support the potential utility of a centralised notification and outbreak management system for CPE positive patients.

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Section: Discussionmentioning

confidence: 99%

Carbapenemase-producing Enterobacterales colonisation status does not lead to more frequent admissions: a linked patient study

Lydeamore,

Donker,

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Carbapenemase-producing enterobacterales colonisation status does not lead to more frequent admissions: a linked patient study

Lydeamore,

Donker,

et al. 2024

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

Background Hospitals in any given region can be considered as part of a network, where facilities are connected to one another – and hospital pathogens potentially spread – through the movement of patients between them. We sought to describe the hospital admission patterns of patients known to be colonised with carbapenemase-producing Enterobacterales (CPE), and compare them with CPE-negative patient cohorts, matched on comorbidity information. Methods We performed a linkage study in Victoria, Australia, including datasets with notifiable diseases (CPE notifications) and hospital admissions (admission dates and diagnostic codes) for the period 2011 to 2020. Where the CPE notification date occurred during a hospital admission for the same patient, we identified this as the ‘index admission’. We determined the number of distinct health services each patient was admitted to, and time to first admission to a different health service. We compared CPE-positive patients with four cohorts of CPE-negative patients, sampled based on different matching criteria. Results Of 528 unique patients who had CPE detected during a hospital admission, 222 (42%) were subsequently admitted to a different health service during the study period. Among these patients, CPE diagnosis tended to occur during admission to a metropolitan public hospital (86%, 190/222), whereas there was a greater number of metropolitan private (23%, 52/222) and rural public (18%, 39/222) hospitals for the subsequent admission. Median time to next admission was 4 days (IQR, 0–75 days). Admission patterns for CPE-positive patients was similar to the cohort of CPE-negative patients matched on index admission, time period, and age-adjusted Charlson comorbidity index. Conclusions Movement of CPE-positive patients between health services is not a rare event. While the most common movement is from one public metropolitan health service to another, there is also a trend for movement from metropolitan public hospitals into private and rural hospitals. After accounting for clinical comorbidities, CPE colonisation status does not appear to impact on hospital admission frequency or timing. These findings support the potential utility of a centralised notification and outbreak management system for CPE positive patients.

show abstract

Screening for carbapenemase-producing enterobacteriaceae following transmission: Experience at a large victorian healthcare facility

Cited by 2 publications

References 0 publications

Carbapenemase-producing Enterobacterales colonisation status does not lead to more frequent admissions: a linked patient study

Carbapenemase-producing Enterobacterales colonisation status does not lead to more frequent admissions: a linked patient study

Carbapenemase-producing enterobacterales colonisation status does not lead to more frequent admissions: a linked patient study

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