Screening and Cohorting of CRE Patients: The Strategic Role of Bed Management in a Monocentric Pre-Post Observational...

Carbapenem-resistant Enterobacterales (CRE) require early identification and appropriate patient placement to prevent in-hospital transmission. Bed Management plays a key organizational role in coordinating screening results and isolation strategies; however, evidence on its impact on patient flow and isolation practices remains limited.

To evaluate whether the implementation of a Bed Management-coordinated structured CRE screening pathway was associated with changes in patient placement appropriateness and time to admission (TTA).

We conducted a retrospective cohort study including all patients with a positive rectal swab for CRE during two study periods (PRE: 2024; POST: 2025) in a tertiary care hospital. A structured CRE screening pathway coordinated by Bed Management was implemented in the POST period. Primary outcomes were cohort isolation rates and TTA. Continuous variables were compared using the Mann-Whitney U test and categorical variables using the chi-square test.

A total of 158 CRE-positive patients were included (69 in the PRE period and 89 in the POST period). Patient characteristics were comparable between periods (median age 75 years [IQR 64-81] vs. 73 years [IQR 64-82]; female sex 33.3% vs. 44.9%, p = 0.189). Cohort isolation rates were higher in the POST period. Median time to admission (TTA) decreased from 74.8 h (IQR 47.2-124.6) in PRE to 70.7 h (IQR 35.1-139.9) in POST; however, this difference did not reach statistical significance (Mann-Whitney U test, p = 0.630).

A Bed Management-coordinated CRE screening pathway was associated with improved cohort isolation practices and an observed, non-significant reduction in TTA. These findings suggest that integrating infection prevention workflows with centralized bed allocation may be feasible without adversely affecting admission timeliness. Further studies with larger samples and longer observation periods are warranted.