513. Targeted MDRO Screening in a Children's Hospital Shows High Rate of Colonization
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: Increasingly hospital acquired infections (HAIs) are due to multi-drug resistant organisms (MDROs). Pennsylvania Act 52 mandated active surveillance for MDROs. We used HAI data and postulated risk factors in order to establish two methods of MDRO screening; targeted screening populations and prolonged hospitalization (LOS >30 days). We prospectively evaluated compliance and rates of colonization for MDROs.
Methods: Targeted populations: long term care/chronic tracheostomy (LTC/tr), Cystic Fibrosis (CF), Sickle Cell Disease (SC), Oncology (Onc), NICU, CCU, > 3 admits/yr and >30 day LOS. Targeted patients were screened upon admission with nasal, skin and rectal swabs for MRSA, VRE and ESBL culture by standard microbiological methods. Screening was linked with isolation while MDRO screen was pending. Targeted populations and >30 day LOS screening compliance was monitored using daily admission logs, microbiology laboratory database and daily unit-patient tracking tool with bedside chart confirmation. Rates of positive screen by targeted population were calculated.
Results: 12% (1270/10847) of total hospital admissions were screened and screening was performed in 96% of eligible patients. Screens were positive in 9% (108/1270) of targeted population representing 1.0% of all hospital admissions. The percent positive by targeted population varied from 5% to 28% (Table). MRSA accounted for 48% of positive screens. $$table_?$$
MDRO ScreenMicrobiology of Positive screen (%)
Pop. TargetTotal ## Pos. (%)VREESBLMRSA
LTC/tr5716 (28%)13%63%31%
CF777 (9%)43%57%14%
SC42729 (7%)3%7%93%
Onc1227 (6%)86%00
NICU33631 (9%)26%52%42%
CCU855 (6%)60%20%20%
≥3 admits799 (11%)22%44%33%
≥30 days LOS874 (5%)50%50%0
TOTAL1270108 (9%)20%35%48%

Conclusions: MDRO colonization on admission was higher than expected and varied by underlying condition. Lowest colonization rate was in those with prolonged current hospitalization. MRSA was the most common MDRO isolated.
Jane M. Gould, MD1, Patricia Hennessey, MSN2, Andrea Kiernan, AAS2, Sarah Long, MD1, Sheila Wood, PhD3 and  J. M. Gould, None..
P. Hennessey, None..
A. Kiernan, None..
S. J. Wood, None..
S. S. Long, None., (1)St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, PA, (2)St. Christopher's Hospital for Children, Philadelphia, PA, (3)St. Christopher's Hospital for Children, Phildelphia, PA