EP 62 - Infection Prevention Resource Impact to Screen Patients Exposed to Carbapenemase-producing Organisms While Admitted to a Tertiary Acute Care Hospital

Background: Incidence of carbapenemase-producing organisms (CPOs) is emerging. Early identification through screening and isolation of infected or colonized patients can help limit transmission. Infection Preventionists (IPs) coordinate point prevalence screening events of patients at risk for transmission after potential exposure. Here we explain the sizeable resource impact for hospitals to carry out these screenings.

Methods: Our large, tertiary care facility was contacted by the state health department to request screening of admitted patients in response to potential exposure to CPOs. In response to six separate requests, from August through November 2023, the IP department coordinated screening of admitted patients. IPs used the hospital electronic medical record to identify potentially exposed patients. IPs selected patients currently admitted and appropriate for screening based on risk factors. Rectal, axilla/groin, and/or wound swabs were collected depending on the organism of interest.

Results: All together the screening events have involved ordering 111 microbiology screening cultures for 68 patients. The number of patients screened per event has ranged from 7 to 15. Fourteen inpatient units and up to six units per screening event have been involved. The vascular surgery unit was the most commonly involved in the screening events. All screening cultures collected were negative for the CPOs involved in the exposures. For these 6 screening events a total of approximately 70 hours of IP time was required.

Conclusions: IP time needed for exposure investigations can be quite large. This is due to the sensitive nature of the disclosure to the patients involved, interdepartmental collaboration, the unique sample collection methodologies, and ordering requirements. Out of an abundance of caution, IP, environmental services, and unit staff partnered to conduct a deep clean of the entire vascular surgery unit. Continued collaboration is needed between acute care and state health departments to streamline requested screenings.