TY - JOUR
T1 - Epidemiology of carbapenem-resistant Enterobacteriaceae in hospitals of a large healthcare system in Miami, Florida from 2012 to 2016
T2 - Five years of experience with an internal registry
AU - Jimenez, Adriana
AU - Trepka, Mary Jo
AU - Munoz-Price, L. Silvia
AU - Pekovic, Vukosava
AU - Ibrahimou, Boubakari
AU - Abbo, Lilian M.
AU - Martinez, Octavio
AU - Sposato, Kathleen
AU - dePascale, Dennise
AU - Perez-Cardona, Armando
AU - McElheny, Christi L.
AU - Bachman, William C.
AU - Fowler, Erin L.
AU - Doi, Yohei
AU - Fennie, Kristopher
N1 - Funding Information:
Conflict of interest: AJ, MJT, VP, BI, OM, DDP, APC, KS, CM, WB, EF, and KF report no potential conflict of interest. LSMP reports receiving grants from Cepheid and served as advisor to Paratek and Entasis. YD reports grants and personal fees from Pfizer, Merck, and Shionogi, grants from Astellas, Kanto Chemical, personal fees from Roche, Tetraphase, Recida, personal fees from Fedora, VenatoRx, Entasis, BD, and bioMerieux, outside the submitted work. LA reports personal fees from Achaogen, Nabriva therapeutics, Paratek, Roche diagnostics, WebMD, Pfizer Latin America, and from MSD, outside the submitted work.
Funding Information:
Conflict of interest: AJ, MJT, VP, BI, OM, DDP, APC, KS, CM, WB, EF, and KF report no potential conflict of interest. LSMP reports receiving grants from Cepheid and served as advisor to Paratek and Entasis. YD reports grants and personal fees from Pfizer, Merck, and Shionogi, grants from Astellas, Kanto Chemical, personal fees from Roche, Tetraphase, Recida, personal fees from Fedora, VenatoRx, Entasis, BD, and bioMerieux, outside the submitted work. LA reports personal fees from Achaogen, Nabriva therapeutics, Paratek, Roche diagnostics, WebMD, Pfizer Latin America, and from MSD, outside the submitted work.
Publisher Copyright:
© 2020 Association for Professionals in Infection Control and Epidemiology, Inc.
PY - 2020/11
Y1 - 2020/11
N2 - Background: Carbapenem-resistant Enterobacteriaceae (CRE) is an urgent public health threat globally. Limited data are available regarding the epidemiology of CRE in South Florida. We describe the epidemiology of CRE within a large public healthcare system in Miami, FL, the experience with an internal registry, active surveillance testing, and the impact of infection prevention practices. Methods: Retrospective cohort study in 4 hospitals from a large healthcare system in Miami-Dade County, FL from 2012 to 2016. The internal registry included all CRE cases from active surveillance testing from rectal and/or tracheal screening occurring in the intensive care units of 2 of the hospitals and clinical cultures across the healthcare system. All CRE cases were tagged in the electronic medical record and automatically entered into a platform for automatic infection control surveillance. The system alerted about new cases, readmissions, and transfers. Results: A total of 371 CRE cases were identified. The overall prevalence was 0.077 cases per 100 patient-admissions; the admission prevalence was 0.019 per 100 patient-admissions, and the incidence density was 1.46 cases per 10,000 patient-days. Rates increased during the first 3 years of the study and declined later to a lower level than at the beginning of study period. Conclusions: Active surveillance testing and the use of an internal registry facilitated prompt identification of cases contributing to control increasing rates of CRE by rapid implementation of infection prevention strategies.
AB - Background: Carbapenem-resistant Enterobacteriaceae (CRE) is an urgent public health threat globally. Limited data are available regarding the epidemiology of CRE in South Florida. We describe the epidemiology of CRE within a large public healthcare system in Miami, FL, the experience with an internal registry, active surveillance testing, and the impact of infection prevention practices. Methods: Retrospective cohort study in 4 hospitals from a large healthcare system in Miami-Dade County, FL from 2012 to 2016. The internal registry included all CRE cases from active surveillance testing from rectal and/or tracheal screening occurring in the intensive care units of 2 of the hospitals and clinical cultures across the healthcare system. All CRE cases were tagged in the electronic medical record and automatically entered into a platform for automatic infection control surveillance. The system alerted about new cases, readmissions, and transfers. Results: A total of 371 CRE cases were identified. The overall prevalence was 0.077 cases per 100 patient-admissions; the admission prevalence was 0.019 per 100 patient-admissions, and the incidence density was 1.46 cases per 10,000 patient-days. Rates increased during the first 3 years of the study and declined later to a lower level than at the beginning of study period. Conclusions: Active surveillance testing and the use of an internal registry facilitated prompt identification of cases contributing to control increasing rates of CRE by rapid implementation of infection prevention strategies.
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U2 - 10.1016/j.ajic.2020.04.013
DO - 10.1016/j.ajic.2020.04.013
M3 - Article
C2 - 32334004
AN - SCOPUS:85084508183
VL - 48
SP - 1341
EP - 1347
JO - American Journal of Infection Control
JF - American Journal of Infection Control
SN - 0196-6553
IS - 11
ER -