A regional informatics platform for coordinated antibiotic-resistant infection tracking, alerting, and prevention

Area of Science:

• Infectious Diseases
• Healthcare Informatics
• Public Health

Background:

• Antimicrobial resistance (AMR) poses a significant public health threat.
• Methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) are key multidrug-resistant organisms.
• Tracking patient movement and infection history across healthcare systems is crucial for effective control.

Purpose of the Study:

• To assess the impact of a regional patient registry and electronic admission notification system on AMR infection rates.
• To evaluate the utility of such a system in identifying patient movement and trends across multiple healthcare facilities.
• To determine the effectiveness of electronic alerts in prompting timely infection control interventions.

Main Methods:

• An observational cohort study was conducted involving 5 healthcare systems in the Indianapolis region from 2003 to 2010.
• A standardized registry of patients with MRSA and/or VRE infections or colonization was developed.
• Electronic alerts were sent to infection preventionists (IPs) for patients with a history of MRSA or VRE admitted to study hospitals.

Main Results:

• Over three years, 12,748 email alerts were sent for 6,270 unique patients to 24 IPs across 17 hospitals.
• Approximately 22-23% of admission alerts involved patients transferring from a different healthcare system than the admitting hospital.
• A small number of hospitals accounted for the majority of inter-institutional patient transfers.

Conclusions:

• Regional patient registries are valuable for identifying patient cohorts with prior antibiotic-resistant infections across different institutions.
• These registries can reveal interinstitutional patient movement and resistance trends not evident from single-institution data.
• Electronic alerts facilitate early notification for isolation and transmission prevention measures.