Implementing an XDRO registry reduced CRE spread, even when only 25% of the largest Illinois facilities participated due to patient sharing. Non-participating facilities garnered benefits, with reductions in new carriers.
We developed an agent-based model of all inpatient healthcare facilities (90 acute care hospitals, 9 long-term acute care hospitals, 351 skilled nursing facilities, and 12 ventilator-capable skilled nursing facilities) in the Chicago metropolitan area, surrounding communities, and patient flow using our Regional Healthcare Ecosystem Analyst software platform. Scenarios explored the impact of a registry that tracked patients carrying CRE to help guide infection prevention and control.
When all Illinois facilities participated (n=402), the registry reduced the number of new carriers by 11.7% and CRE prevalence by 7.6% over a 3-year period. When 75% of the largest Illinois facilities participated (n=304), registry use resulted in a 11.6% relative reduction in new carriers (16.9% and 1.2% in participating and non-participating facilities, respectively) and 5.0% relative reduction in prevalence. When 50% participated (n=201), there were 10.7% and 5.6% relative reductions in incident carriers and prevalence, respectively. When 25% participated (n=101), there was a 9.1% relative reduction in incident carriers (20.4% and 1.6% in participating and non-participating facilities, respectively) and 2.8% relative reduction in prevalence.
Regions are considering the use of electronic registries to track patients that carry antibiotic-resistant bacteria including carbapenem-resistant Enterobacteriaceae (CRE). Implementing such a registry can be challenging and requires time, effort, and resources; therefore, there is a need to better understand the potential impact.
Lee BY, Bartsch SM, Hayden MK, Welling J, DePasse JV, Kemble SK, Leonard J, Weinstein RA, Mueller LE, Doshi K, Brown ST, Trick WE, Lin MY. (2019). How Introducing a Registry with Automated Alerts for Carbapenem-Resistant Enterobacteriaceae (CRE) May Help Control CRE Spread in a Region. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America