Implementation, Outcomes and Evaluation of Hospital-Wide MRSA Active Surveillance Culture (ASC) Program

2009 ◽  
Vol 37 (5) ◽  
pp. E76
Keyword(s):  
Active Surveillance ◽  
Surveillance Culture ◽  
Implementation Outcomes ◽  
Active Surveillance Culture

P24.03 ESBL active surveillance culture in patients rehospitalized from other facilities and nursing homes

2010 ◽  
Vol 76 ◽  
pp. S68
Author(s):  
H. Kunishima ◽  
J. Chiba ◽  
M. Hatta ◽  
K. Nishimaki ◽  
M. Yamada ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Active Surveillance ◽  
Surveillance Culture ◽  
Active Surveillance Culture

Impact of a Methicillin-Resistant Staphylococcus Aureus Active Surveillance Culture Protocol on Mupirocin Prescribing

2009 ◽  
Vol 44 (9) ◽  
pp. 781-784
Author(s):  
Marisel Segarra-Newnham ◽  
Kristin St. John
Keyword(s):  
Staphylococcus Aureus ◽  
Active Surveillance ◽  
Nasal Swab ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Inpatient Setting ◽  
Surveillance Culture ◽  
Methicillin Resistant ◽  
The Impact ◽  
Active Surveillance Culture

Background To identify patients colonized with methicillin-resistant Staphylococcus aureus (MRSA), an active surveillance culture (ASC) protocol has been in place since March 2007. Decolonization with mupirocin ointment is not recommended but may be attempted after a positive MRSA screen. Objective Assess the impact of an inpatient ASC protocol on prescribing of mupirocin nasal ointment for decolonization before and after protocol implementation. Methods A retrospective review of mupirocin inpatient prescribing and outpatient clinic requests from March 2006 through February 2007 (1 year before ASC implementation) and from March 2007 through February 2008 (1 year after ASC implementation) was conducted. Cultures for MRSA after decolonization were evaluated. Results During the 24 months reviewed, 38 inpatients received mupirocin (18 before and 20 after ASC). Only 14 patients (37%) had a follow-up nasal swab (5 before and 9 after ASC). Of these patients, 5 (36%) had a positive nasal swab after the initial decolonization attempt. Ten patients (26%) had at least 1 clinical culture positive for MRSA after the initial decolonization (7 before and 3 after ASC). Outpatient requests for mupirocin increased 2.5-fold after ASC implementation. Sixty percent of the requests were not appropriate. Conclusion After implementation of the ASC protocol, there was no change in mupirocin prescribing for decolonization in the inpatient setting. However, outpatient requests—most of which were not indicated—increased. Success of decolonization cannot be assessed because follow-up nasal screening was not universally performed.

A cost analysis of active surveillance culture in a neonatal intensive care unit

2019 ◽  
Vol 20 (3) ◽  
pp. 139-149
Author(s):  
Taito Kitano ◽  
Kumiko Takagi ◽  
Ikuyo Arai ◽  
Hajime Yasuhara ◽  
Reiko Ebisu ◽  
...  
Keyword(s):  
Intensive Care ◽  
Cost Analysis ◽  
Active Surveillance ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Horizontal Transmission ◽  
Surveillance Culture ◽  
Total Cost ◽  
The Cost ◽  
Active Surveillance Culture

Active surveillance culture (ASC) in neonatal intensive care units (NICUs) has been implemented to monitor horizontal transmission and choose appropriate antimicrobials when neonates experience late-onset infections (LOIs). To perform a cost analysis of ASC in the NICU, we evaluated data from a NICU ward in a Japanese community hospital. This was a retrospective study of neonates admitted to the NICU of Nara Prefecture General Medical Center, Nara City, Japan, from April 2012 to May 2017. We implemented biweekly ASC (nasal, stool and umbilical cultures) during this period. We assessed the detection rate for methicillin-sensitive and -resistant S. aureus (MSSA and MRSA) in each culture and reviewed the cases of LOI. Among the 785 cases, MSSA and MRSA were detected in 158 and 75 cases, respectively. Nasal culture was the most sensitive method for detecting MSSA and MRSA. Three cases benefitted from changing the empiric treatment based on previous ASC results, with an annual cost of ¥808,331 (£5773.80 or $7282.30) for ASC. The total cost per one benefited case during the study period was calculated as ¥1,392,126 (£9943.80 or $12,541.70). The total cost per benefited case in risk factor targeted ASC, nasal culture targeted ASC and MRSA-targeted ASC was ¥1,332,264 (£9516.20 or $12,002.30), ¥692,222 (£4944.40 or $6236.20) and ¥858,547 (£6132.50 or $7734.70), respectively. Considering the frequency of S. aureus detection and the cost of each culture, our ASC was modified to use only nasal cultures. This study suggests that the cost performance of ASC should be evaluated with consideration of the characteristics of each NICU.

scholarly journals 2455. Outbreak of carbapenemase-producing Enterobacteriaceae in cardiology units associated with contaminated water dispenser and sink drain in Korea

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S849-S850
Author(s):  
Jiwon Jung ◽  
Hye-Suk Choi ◽  
Jeong-Young Lee ◽  
Min Jee Hong ◽  
Sun Hee Kwak ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Tertiary Care ◽  
Water Environment ◽  
Water System ◽  
Contact Tracing ◽  
Contact Precaution ◽  
Surveillance Culture ◽  
Care Hospital ◽  
Patient Room ◽  
Large Outbreak

Abstract Background There is a growing concern about the importance of hospital water environment for the transmission of carbapenemase-producing Enterobacteriaceae (CPE). Herein, we report a large outbreak in cardiology units involving intensive care units (ICU) and wards at a tertiary care hospital. Methods During a CPE outbreak between July and December 2018, contact tracing and environmental sampling were performed. For outbreak control, we performed education to healthcare workers, hand hygiene enforcement, active surveillance test, preemptive isolation, chlorhexidine bathing for CPE positive patients, and deep terminal cleaning including UV and hydrogen peroxide non-touch disinfection. Patients with CPE were isolated at a single room with dedicated staffs, contact precaution was implemented, and when case patients were located in multi-patient room, we performed surveillance culture for exposed patients in the room. Results A total of 87 patients with CPE infection or colonization were identified at two cardiology ICUs and three cardiology wards. CPE from the first two index patients were identified from sputum culture suspecting pneumonia, and the remaining 85 patients were identified to harbor CPE through surveillance culture (exposed patients n = 22, active surveillance test n = 63). Diverse organisms were identified; organisms with blakpc (n = 13), blaNDM-1 (n = 55), blaVIM or blaIMP (n = 12), blaOXA-48 (n = 3), and co-producing organisms (n = 4). We performed environmental culture; KPC-producing Escherichia coli was isolated from water dispenser in ICU and NDM-1 producing Citrobacter freundii and Enterobacter cloacae were isolated from sinks in the patient room. Outbreak ended after the removal of water dispenser and the replacement of sink drain with pouring bleach to the sink drain. Conclusion Water dispenser and sink drain were suspected for the possible reservoirs of CPE in this outbreak. Replacement of plumbing system and use of bleach for pouring to sink as well as the removal of water dispenser was needed to control outbreak. Investigation of water system is warranted for finding the source of CPE. Disclosures All authors: No reported disclosures.

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