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Admission screening and cohort care decrease carbapenem resistant enterobacteriaceae in Vietnamese pediatric ICU's

K Garpvall1, V Duong2, S Linnros1

  • 1Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18B 4fl, 171 77, Stockholm, Sweden.

Antimicrobial Resistance and Infection Control
|August 31, 2021
PubMed

Insights

Admission screening for Carbapenem-Resistant Enterobacteriaceae (CRE) and cohort care significantly reduced CRE acquisition and hospital-acquired infections (HAI) in pediatric ICUs. This strategy also decreased hospital stays and associated treatment costs.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Public Health

Background:

  • Carbapenem-Resistant Enterobacteriaceae (CRE) pose a significant threat in healthcare settings, particularly in Intensive Care Units (ICUs).
  • Effective strategies are needed to curb the spread of CRE and its associated complications, such as Hospital-Acquired Infections (HAI).

Purpose of the Study:

  • To evaluate the impact of admission screening for CRE and subsequent cohort care on reducing CRE acquisition.
  • To assess the effect of this intervention on HAI rates, hospital stay duration, mortality, and treatment costs in pediatric ICUs.

Main Methods:

  • Implementing CRE screening using rectal swabs and selective culture upon admission and weekly for negative patients.
  • Utilizing cohort care strategies based on patients' CRE colonization status.
  • Stratifying patients into time-based groups to analyze changes in CRE acquisition over time.

Main Results:

  • A significant decrease in CRE acquisition was observed, from 90% to 48% over the study periods (OR=3.2, p<0.005).
  • Patients with CRE acquisition experienced higher rates of culture-confirmed HAI (14% vs. 2%), longer hospital stays (3.26 vs. 2.37 weeks), and increased treatment costs ($2852 vs. $2295).

Conclusions:

  • Admission CRE screening combined with cohort care is an effective strategy to reduce CRE acquisition in pediatric ICUs.
  • This intervention leads to a significant reduction in HAI cases and hospital stay duration, contributing to better patient outcomes and resource management.
Abstract

Keywords:
Admission screeningCarbapenem resistant EnterobacteriaceaeCohort careHospital acquired infectionsPediatric and neonatal care

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