Methods: We compared remnant diarrhea specimens submitted for C difficile toxin PCR (n = 400 patients) and remnant VRE perianal swabs (n = 400 patients) to determine the superiority of one specimen type over the other for CRE carriage. Specimens were analyzed using both the disk method and broth method recommended by CDC. Carbapenem resistance was confirmed by ertapenem and meropenem disk diffusion testing. Putative ertapenem resistant isolates were identified by Matrix Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry (MALDI-TOF).
Results: Two percent of the patients (8/400) from the universal surveillance arm (VRE) were found to harbor CRE. Six percent of the patients (24/400) from the targeted surveillance arm (C. difficile) were found to harbor CRE. This difference was significant (p value of <0.0039) enabling us to conclude that use of targeted specimens was superior in the ability to identify CRE from facilities with low clinical incidence of these microbes.
Conclusion: Use of targeted surveillance through screening remnant C. difficile diarrhea specimens was significantly better in its ability to detect CRE colonized patients than was universal surveillance using remnant VRE perianal swabs.
M. G. Schmidt, None