2178. Detection of Key Potential Healthcare Pathogens Using Periodic Point Prevalence Surveillance
Session: Poster Abstract Session: Healthcare Epidemiology: HAI Surveillance
Saturday, October 6, 2018
Room: S Poster Hall
Posters
  • 2018 ID Week Schora Point Prevalence.pdf (479.2 kB)
  • Background: Surveillance for asymptomatic carriage of multidrug resistant (MDR) pathogens is useful to determine the burden of these organisms and help guide infection prevention strategy. We currently perform surveillance cultures for gram negative multidrug resistant pathogens (GNMDR) in the ICUs on a monthly basis. We added a quarterly point prevalence survey to all hospital units for these and other key pathogens over one year to determine if our program should expand beyond the ICU and include other organisms.

    Methods:

    Rectal samples were collected quarterly for one year starting June 2016 at NorthShore University HealthSystem, a 4-hospital, 789 bed system. All hospitalized patients present on the day of the point prevalence testing had a double-headed rectal swab collected. One swab was plated to VACC agar (Remel) for culture of GNMDR and VRE, and the second was plated to CCFAHT (Anaerobe Systems) for C. difficile (Cdif) culture. All samples were collected on a specified day at each of our 4 hospitals, one hospital per week, and sent to the central microbiology lab for processing. Testing for GNMDR included the following pathogens: Carbapenem resistant Enterobacteriaceae (CRE), ESBLs, and Gram negative organisms susceptible to ≤2 drug classes.

    Results: A total of 987 surveillance samples were collected. The number of patients with MDR in the ICU vs. non-ICU units is described in Table 1. There was an 11% greater difference in the percentage of patients colonized with GNMDR and Cdif in non-ICU patients compared to ICU patients (p =0.006). An important discovery was 3 patients colonized with CRE outside the ICU that were previously unknown. The burden of ESBL, VRE and Cdif carriage was also greater outside the ICU.

    Table 1. Comparison of Patients in ICU vs. Non-ICU with Important Hospital Pathogens

    Number of patients with :

    No. Tests

    Important Pathogens (%)

    ESBL

    CRE

    MDR

    VRE

    Toxigenic Cdif

    Non-ICU

    833

    175 (21%)

    79

    3

    5

    64

    47

    ICU

    154

    17 (11%)

    10

    2

    1

    1

    7

    Conclusion:

    The point prevalence surveillance uncovered a significant amount of MDRs in our non-ICU units, particularly 3 CRE that were previously unknown. These results suggest there is a large burden of MDR organisms outside the ICU.

    Donna Schora, MT(ASCP)1, Michael O. Vernon, DrPH1, Adrienne Fisher, MT(ASCP)CIC1, Bridget Kufner, MT(ASCP) CIC1, Mona Shah, MPH, CIC2, Rachel Lim, RN, CIC1, Vanida Komutanon, RN, CIC1, Crystal Bockoven, MD1, Richard Thomson Jr., PhD3, Lance Peterson, MD1 and Kamaljit Singh, MD4, (1)NorthShore University HealthSystem, Evanston, IL, (2)Infection Control and Prevention, NorthShore University HealthSystem, Evanston, IL, (3)Pathology and Laboratory Medicine, NorthShore University HealthSystem, Evanston, IL, (4)Pathology, Evanston Hospital/NorthShore University HealthSystem, Evanston, IL

    Disclosures:

    D. Schora, None

    M. O. Vernon, None

    A. Fisher, None

    B. Kufner, None

    M. Shah, None

    R. Lim, None

    V. Komutanon, None

    C. Bockoven, None

    R. Thomson Jr., None

    L. Peterson, None

    K. Singh, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.