Value of an active surveillance policy to document clearance of meticillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci amongst inpatients with prolonged admissions

Ghosh, Ananda; Jiao, Lei; AlMutawa, Fatimah; O’Neill, Cindy; Mertz, Dominik

doi:10.1016/j.jhin.2014.09.011

Cited by 14 publications

(6 citation statements)

References 10 publications

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“…In healthcare epidemiology, many studies have measured increased or attributable costs related to HAI, 12,[54][55][56][57][58][59][60] while others have evaluated the cost or cost-effectiveness of interventions. [61][62][63][64][65] A recent study utilized several different administrative datasets to estimate the potential cost-benefit of CDI reduction. 66 In any attempt to analyze costs of infections or of their prevention, an understanding of charges versus actual costs is critical.…”

Section: Pitfalls and Tipsmentioning

confidence: 99%

Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship: Use of Administrative and Surveillance Databases

Drees

Gerber

Morgan

et al. 2016

Infect. Control Hosp. Epidemiol.

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Administrative and surveillance data are used frequently in healthcare epidemiology and antimicrobial stewardship (HE&AS) research because of their wide availability and efficiency. However, data quality issues exist, requiring careful consideration and potential validation of data. This methods paper presents key considerations for using administrative and surveillance data in HE&AS, including types of data available and potential use, data limitations, and the importance of validation. After discussing these issues, we review examples of HE&AS research using administrative data with a focus on scenarios when their use may be advantageous. A checklist is provided to help aid study development in HE&AS using administrative data. Infect Control Hosp Epidemiol 2016;1-10.

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Section: Pitfalls and Tipsmentioning

confidence: 99%

Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship: Use of Administrative and Surveillance Databases

Drees

Gerber

Morgan

et al. 2016

Infect. Control Hosp. Epidemiol.

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“…72 Most studies investigating the duration of VRE colonization duration have used gastrointestinal tract samples, 63 stool samples, 14,19 and perirectal and perineal swabs, 20,67,68,73 or both. 12,60 Some studies have included surveillance cultures obtained from other sites including throat and urine samples. 16 While limited, data comparing the sensitivity of rectal and perirectal cultures suggest that both are comparable.…”

Section: Sites Of Colonizationmentioning

confidence: 99%

“…Some studies have documented shorter duration of colonization. Ghosh et al 60 examined patients with prolonged hospital stays and used active surveillance to identify patients that lose MRSA carriage. They observed a clearance rate of 11% for MRSA with a median time to clearance of 23 days, although 4 of these 19 patients were later found to be recolonized with MRSA.…”

Section: Methicillin-resistant Staphylococcus Aureus (Mrsa)mentioning

confidence: 99%

Duration of Contact Precautions for Acute-Care Settings

Banach

Bearman

Barnden³

et al. 2018

Infect. Control Hosp. Epidemiol.

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purposeThis expert guidance document (EG) provides recommendations regarding discontinuation of contact precautions (CP) at the individual patient level in acute-care hospitals employing CP for 1 or more of the following organisms: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Clostridium difficile, and multidrug-resistant Enterobacteriaceae (MDR-E), including carbapenem-resistant Enterobacteriaceae (CRE) and extended-spectrum β-lactamase (ESBL)-producing organisms. This document also provides a review of the role of molecular testing in guiding decisions pertaining to duration of CP for patients with these organisms. The guidance does not address decisions regarding the initiation of CP for any specific organism.Previously published guidelines describe components of CP and identify situations in which CP should be used; currently, however, few publications address the issue of how long CP should be maintained. At the time of publication, decisions related to implementation of CP for select, endemic organisms are made by individual facilities based on factors such as institutional epidemiology, resources, organizational priorities, and previously published guidance, and these vary widely. The SHEA Guidelines Committee (GLC) selected this topic to address when CP should be discontinued for individual patients in acute-care settings that employ CP for the aforementioned organisms.Although the organisms addressed are frequently encountered in other settings (eg, nursing homes, long-term acute-care facilities, rehabilitation centers, outpatient medical care settings), additional considerations may affect the application of these recommendations outside the acute-care hospital environment. authorsThe authors consist of current and past members of the SHEA Guidelines Committee (GLC), who serve as volunteers. All authors are involved at their respective institutions in the development of policies pertaining to CP, either directly or in an advisory role. intended useSpecial-topic EG documents are developed to address areas of relatively narrow scope that lack the level of evidence required for a formal guideline but are important for the provision of safe and effective healthcare. As such, systematic grading of evidence level is not provided for individual recommendations. Each EG is based on a synthesis of limited evidence, theoretical rationale, current practices, practical considerations, the opinion of the writing group, and consideration of potential harms where applicable. Within the EG, a summary list of recommendations is provided, along with their respective rationales. We also conducted a survey of the SHEA Research Network (SRN).No EG can anticipate all situations and this EG is not meant to be a substitute for individual judgment by qualified professionals. methods Expert Guidance DevelopmentThis EG follows the process outlined in the Handbook for SHEA-Sponsored Guidelines and Expert Guidance Documents. 10 The topic of duration of CP was among those proposed and ...

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“…In 2014, regarding both MRSA and VRE colonization, Ghosh et al [23] found that in 365 patients who were initially positive for either (but not both) microorganism and were also hospitalized over 30 days, 11% became MRSA negative and 18% VRE negative [23]. They estimated that this resulted in saving 2152 patient-days of patient precautions over one year, and therefore that reswabbing is cost-effective.…”

Section: When Is It Appropriate To Deisolate Patients?mentioning

confidence: 99%

Patient Isolation Precautions: Are They Worth It?

Sprague

Reynolds

Brindley

2016

Canadian Respiratory Journal

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Isolation precautions are intended to minimize pathogen transmission and reduce hospital-acquired infections. More recently, the effectiveness of isolation precautions has been questioned because of increasing evidence of risks. These putative downsides are divided into a quantifiable monetary cost (i.e., a literal cost to the system) and clinically important but less easily quantifiable costs (i.e., “costs” to the patient). The authors also briefly review deisolation and alternatives to isolation. The present review is not arguing against appropriate isolation or precautions, simply that the authors consider both risks and benefits and disseminate up-to-date information. Their patient-focused goal is to mitigate risks for those who truly need isolating and to end isolation as soon as it is safe and appropriate to do so.

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Value of an active surveillance policy to document clearance of meticillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci amongst inpatients with prolonged admissions

Cited by 14 publications

References 10 publications

Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship: Use of Administrative and Surveillance Databases

Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship: Use of Administrative and Surveillance Databases

Duration of Contact Precautions for Acute-Care Settings

Patient Isolation Precautions: Are They Worth It?

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