321. A Hospital Based VRE Screening for Patients with Hematological Malignancies: A Cost Benefit Analysis
Session: Poster Abstract Session: Assessing and Reducing Infection Risk
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • IDSA-VRE-1.pdf (3.6 MB)
  • Background:

    Vancomycin Resistant Enterococcus (VRE) is one of the major causes of increasing morbidity and mortality among hospitalized immunosuppressed patient groups. Hospital acquired VRE infection is also strongly associated with rising healthcare costs. Nosocomial bloodstream infection (BSI) is responsible for extending hospital length of stay (LOS) by 7 to 21 days. The additional costs associated with prolonged LOS may range from $3,000 to $40,000 per patient.

    Methods: 

    A single-center, retrospective data collection of patients with documented hematological malignancies admitted September 2009 through August 2010. 148 patients were identified and data collected on basic demographics, clinical measures, VRE status, and LOS. The costs associated with VRE screening cultures (laboratory and nursing) and the costs of instituting infection control measures were calculated. The primary objective was to determine the cost-effectiveness of screening high-risk immunosuppressed patients for VRE colonization on admission to the hospital.

    Results: 

    29 (20%) out of 148 patients were positive for VRE screening on admission. 30 (20 %) patients converted to VRE positive colonization during hospitalization.10 (17%) of 59 colonized patients developed VRE bacteremia during hospitalization. 90 % of the VRE colonized patients had neutropenia on the day of admission and during hospitalization. The mean isolation duration was 25 days for VRE colonized patients. The cost of screening 148 patients for the year was approximately $ 2,440. Whereas the average cost of implementing recommended infection control measures per patient was $4,850. And the total cost of instituting recommended infection control measures for the year was approximately $286,150. The total cost of treating 10 patients with VRE bacteremia was approximately $300,000.

    Conclusion: 

    It is cost-effective to screen all patients with hematological malignancies in high-risk settings. Routine pre-admission screening helps in early detection of VRE in colonized high-risk patients, minimizes the development of subsequent BSI and results in reduced nosocomial transmission. 


    Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

    Georgina Nasr, MD1, Deepti Canchi, MD2, John Large, PhD2, Stacy Martin, RN3, Rod Quilitz, PharmD3 and John Greene, MD3,4, (1)Infectious Diseases, University of South Florida, Tampa, FL, (2)Health Policy and Management, University of South Florida, Tampa, FL, (3)H. Lee Moffitt Cancer Center, Tampa, FL, (4)University of South Florida, Tampa, FL

    Disclosures:

    G. Nasr, None

    D. Canchi, None

    J. Large, None

    S. Martin, None

    R. Quilitz, None

    J. Greene, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.