CRE were first detected in CA in 2010. Understanding the emergence of this MDRO due to inter-facility patient-sharing enables targeted interventions for containment.
We identified patients testing positive for CRE between 1/1/2010 and 12/31/2013 at an academic medical center and assessed their demographic characteristics. We then linked patient data to two line-item state hospital and nursing home datasets to capture inter-facility patient sharing and define the frequency of CRE exposures to other regional facilities. We assessed the number and type of admissions to healthcare facilities in the year prior to and following the confirmed CRE culture.
In the four years under study, 54 patients tested positive for CRE and had linked entries in the hospital and nursing home databases (requires SSN). Of the 54 patients, 52% were female with mean age = 66 (SD=17). In 89%, CRE was found during hospitalization, with mean length of stay (LOS) = 30.7 (SD=31.9) days. In the year prior to CRE identification, patients visited healthcare facilities 202 times with 1,902 hospital days. In the year following diagnosis, 19 (35%) died. These 19 visited 56 facilities and generated 177 CRE-exposure hospital days prior to their deaths. Together, all CRE positive patients made 137 healthcare visits resulting in 2,298 exposure days within a year of discharge from their hospitalization in which CRE was found (Table).
CRE has emerged in California, predominantly in patients with multiple comorbid conditions. Due to these comorbidities, CRE carriers produce substantial inter-facility exposure due to their frequent admissions to multiple hospitals and nursing homes.
S. M. Cousins,
C. Cao, None
S. S. Huang, Sage Products: Conducting studies in which participating healthcare facilities are receiving product from Sage Inc , Contributed product for ABATE Study
Molnlycke: Conducting studies in which participating healthcare facilities are receiving product from Molnlycke , Contributed product for ABATE Study
3M: Conducting studies in which participating healthcare facilities are receiving product from 3M , Conducting studies in which participating healthcare facilities are receiving product from 3M
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