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The associated impact of standardized admission screening on vancomycin-resistant Enterococci bloodstream infections

Published online by Cambridge University Press:  06 October 2022

Ted R. Pfister Open the ORCID record for Ted R. Pfister [Opens in a new window] ,
Blanda Chow ,
Ye Shen Open the ORCID record for Ye Shen [Opens in a new window] ,
Jennifer Ellison Open the ORCID record for Jennifer Ellison [Opens in a new window]  and
Kathryn Bush
Ted R. Pfister*
Affiliation:
Infection Prevention and Control, Alberta Health Services, Calgary, Alberta, Canada
Blanda Chow
Affiliation:
Infection Prevention and Control, Alberta Health Services, Calgary, Alberta, Canada
Ye Shen
Affiliation:
Infection Prevention and Control, Alberta Health Services, Calgary, Alberta, Canada
Jennifer Ellison
Affiliation:
Infection Prevention and Control, Alberta Health Services, Calgary, Alberta, Canada
Kathryn Bush
Affiliation:
Infection Prevention and Control, Alberta Health Services, Calgary, Alberta, Canada
*
Author for correspondence: Ted R. Pfister, E-mail: Ted.Pfister@ahs.ca
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Abstract

Objective:

To determine whether discontinuing active screening for vancomycin-resistant Enterococcus (VRE) in Alberta, Canada, acute-care facilities had an associated impact on the rate of rise of hospital-acquired (HA) VRE bloodstream infection (VRE-BSI).

Setting:

Acute-care facilities in Alberta, Canada.

Patients:

All patients who were admitted to Alberta Health Services or Covenant Health acute-care facilities between January 1, 2013, and March 31, 2020, and who met the definition for hospital-acquired VRE-BSI were included in the analyses.

Methods:

An intervention time-series Poisson regression was used to determine the slope change in VRE incidence between the pre- and postintervention (screening) periods. The patient population was separated into 3 cohorts: group 1 (low risk, VRE screening stopped), group 2 (high risk, VRE screening stopped), and group 3 (high risk, VRE screening continued). For all groups, a level- and slope-change model was used.

Results:

We did not find a statistically significant difference in the slope change or rate of rise in VRE-BSI before and after the intervention, with incidence rate ratio (IRRs) of 1.015 (95% confidence interval [CI], 0.982–1.049), 1.025 (95% CI, 0.967–1.086), and 0.989 (95% CI, 0.924–1.059) for groups 1, 2 and 3, respectively.

Conclusions:

In Alberta, the rate of HA VRE-BSI has remained consistent, and our findings indicate that there has been no increase in the rate of rise of HA VRE-BSI in sites or units that discontinued screening for VRE, regardless of patient risk group.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 44 , Issue 8 , August 2023 , pp. 1289 - 1293
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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