Epidemiology of carbapenem-resistant Enterobacteriaceae in hospitals of a large healthcare system in Miami, Florida from 2012 to 2016: Five years of experience with an internal registry
•Descriptive epidemiology of Carbapenem-resistant Enterobacteriaceae (CRE) in 4 hospitals of large healthcare system in Miami.•Prevalence and incidence rates increased from 2012 to 2014 and declined from 2015 to 2016.•Infection prevention interventions contributed to control increasing CRE rates.•Sc...
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| Veröffentlicht in: | American journal of infection control 2020-11, Vol.48 (11), p.1341-1347 |
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| creator | Jimenez, Adriana Trepka, Mary Jo Munoz-Price, L. Silvia Pekovic, Vukosava Ibrahimou, Boubakari Abbo, Lilian M. Martinez, Octavio Sposato, Kathleen dePascale, Dennise Perez-Cardona, Armando McElheny, Christi L. Bachman, William C. Fowler, Erin L. Doi, Yohei Fennie, Kristopher |
| description | •Descriptive epidemiology of Carbapenem-resistant Enterobacteriaceae (CRE) in 4 hospitals of large healthcare system in Miami.•Prevalence and incidence rates increased from 2012 to 2014 and declined from 2015 to 2016.•Infection prevention interventions contributed to control increasing CRE rates.•Screening cultures of intensive care unit patients enabled early detection of cases.•An internal electronic registry system allowed rapid identification of readmissions.
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.
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.
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.
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. |
| doi_str_mv | 10.1016/j.ajic.2020.04.013 |
| format | Article |
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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.
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.
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.
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.</description><identifier>ISSN: 0196-6553</identifier><identifier>EISSN: 1527-3296</identifier><identifier>DOI: 10.1016/j.ajic.2020.04.013</identifier><identifier>PMID: 32334004</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Active surveillance testing, Infection prevention and control ; Bacterial ; Carbapenemase producing Enterobacteriaceae ; Carbapenems ; Drug Resistance ; Multidrug resistant organisms registry ; Multiple ; South Florida</subject><ispartof>American journal of infection control, 2020-11, Vol.48 (11), p.1341-1347</ispartof><rights>2020 Association for Professionals in Infection Control and Epidemiology, Inc.</rights><rights>Copyright © 2020 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-bfc5b0b0173abdd9d5636d16fa9f3c42491fd89cbb1dbcd561fcc6b49c7b45233</citedby><cites>FETCH-LOGICAL-c356t-bfc5b0b0173abdd9d5636d16fa9f3c42491fd89cbb1dbcd561fcc6b49c7b45233</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S019665532030239X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32334004$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jimenez, Adriana</creatorcontrib><creatorcontrib>Trepka, Mary Jo</creatorcontrib><creatorcontrib>Munoz-Price, L. Silvia</creatorcontrib><creatorcontrib>Pekovic, Vukosava</creatorcontrib><creatorcontrib>Ibrahimou, Boubakari</creatorcontrib><creatorcontrib>Abbo, Lilian M.</creatorcontrib><creatorcontrib>Martinez, Octavio</creatorcontrib><creatorcontrib>Sposato, Kathleen</creatorcontrib><creatorcontrib>dePascale, Dennise</creatorcontrib><creatorcontrib>Perez-Cardona, Armando</creatorcontrib><creatorcontrib>McElheny, Christi L.</creatorcontrib><creatorcontrib>Bachman, William C.</creatorcontrib><creatorcontrib>Fowler, Erin L.</creatorcontrib><creatorcontrib>Doi, Yohei</creatorcontrib><creatorcontrib>Fennie, Kristopher</creatorcontrib><title>Epidemiology of carbapenem-resistant Enterobacteriaceae in hospitals of a large healthcare system in Miami, Florida from 2012 to 2016: Five years of experience with an internal registry</title><title>American journal of infection control</title><addtitle>Am J Infect Control</addtitle><description>•Descriptive epidemiology of Carbapenem-resistant Enterobacteriaceae (CRE) in 4 hospitals of large healthcare system in Miami.•Prevalence and incidence rates increased from 2012 to 2014 and declined from 2015 to 2016.•Infection prevention interventions contributed to control increasing CRE rates.•Screening cultures of intensive care unit patients enabled early detection of cases.•An internal electronic registry system allowed rapid identification of readmissions.
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.
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.
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.
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.</description><subject>Active surveillance testing, Infection prevention and control</subject><subject>Bacterial</subject><subject>Carbapenemase producing Enterobacteriaceae</subject><subject>Carbapenems</subject><subject>Drug Resistance</subject><subject>Multidrug resistant organisms registry</subject><subject>Multiple</subject><subject>South Florida</subject><issn>0196-6553</issn><issn>1527-3296</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kc2O0zAUhSMEYsrAC7BAXrIgxT-JWyM2aNQC0iA2sLau7ZvWVRIH2x3Io_F2ONOBJau78Dnf8b2nql4yumaUybenNZy8XXPK6Zo2a8rEo2rFWr6pBVfycbWiTMlatq24qp6ldKKUKiHbp9WV4EI0lDar6vdu8g4HH_pwmEnoiIVoYMIRhzpi8inDmMluzBiDAVuGB4uAxI_kGNLkM_Rp8QHpIR6QHBH6fCwUJGlOGYdF-cXD4N-QfR-id0C6GAbCKeMkh2XKd2Tv75DMCPEehr-mEoSjRfLT5yOBsVBK9gg9iXgov4rz8-pJV7LxxcO8rr7vd99uPtW3Xz9-vvlwW1vRylybzraGGso2AoxzyrVSSMdkB6oTtuGNYp3bKmsMc8aWV9ZZK02j7MY0bbnTdfX6wp1i-HHGlPXgk8W-hxHDOWkuVLPdctUuUn6R2hhSitjpKfoB4qwZ1Utl-qSXyvRSmaaNLpUV06sH_tkM6P5Z_nZUBO8vAixb3nmMOtn72zgf0Wbtgv8f_w--CarK</recordid><startdate>20201101</startdate><enddate>20201101</enddate><creator>Jimenez, Adriana</creator><creator>Trepka, Mary Jo</creator><creator>Munoz-Price, L. Silvia</creator><creator>Pekovic, Vukosava</creator><creator>Ibrahimou, Boubakari</creator><creator>Abbo, Lilian M.</creator><creator>Martinez, Octavio</creator><creator>Sposato, Kathleen</creator><creator>dePascale, Dennise</creator><creator>Perez-Cardona, Armando</creator><creator>McElheny, Christi L.</creator><creator>Bachman, William C.</creator><creator>Fowler, Erin L.</creator><creator>Doi, Yohei</creator><creator>Fennie, Kristopher</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20201101</creationdate><title>Epidemiology of carbapenem-resistant Enterobacteriaceae in hospitals of a large healthcare system in Miami, Florida from 2012 to 2016: Five years of experience with an internal registry</title><author>Jimenez, Adriana ; Trepka, Mary Jo ; Munoz-Price, L. Silvia ; Pekovic, Vukosava ; Ibrahimou, Boubakari ; Abbo, Lilian M. ; Martinez, Octavio ; Sposato, Kathleen ; dePascale, Dennise ; Perez-Cardona, Armando ; McElheny, Christi L. ; Bachman, William C. ; Fowler, Erin L. ; Doi, Yohei ; Fennie, Kristopher</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-bfc5b0b0173abdd9d5636d16fa9f3c42491fd89cbb1dbcd561fcc6b49c7b45233</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Active surveillance testing, Infection prevention and control</topic><topic>Bacterial</topic><topic>Carbapenemase producing Enterobacteriaceae</topic><topic>Carbapenems</topic><topic>Drug Resistance</topic><topic>Multidrug resistant organisms registry</topic><topic>Multiple</topic><topic>South Florida</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jimenez, Adriana</creatorcontrib><creatorcontrib>Trepka, Mary Jo</creatorcontrib><creatorcontrib>Munoz-Price, L. 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Silvia</au><au>Pekovic, Vukosava</au><au>Ibrahimou, Boubakari</au><au>Abbo, Lilian M.</au><au>Martinez, Octavio</au><au>Sposato, Kathleen</au><au>dePascale, Dennise</au><au>Perez-Cardona, Armando</au><au>McElheny, Christi L.</au><au>Bachman, William C.</au><au>Fowler, Erin L.</au><au>Doi, Yohei</au><au>Fennie, Kristopher</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epidemiology of carbapenem-resistant Enterobacteriaceae in hospitals of a large healthcare system in Miami, Florida from 2012 to 2016: Five years of experience with an internal registry</atitle><jtitle>American journal of infection control</jtitle><addtitle>Am J Infect Control</addtitle><date>2020-11-01</date><risdate>2020</risdate><volume>48</volume><issue>11</issue><spage>1341</spage><epage>1347</epage><pages>1341-1347</pages><issn>0196-6553</issn><eissn>1527-3296</eissn><abstract>•Descriptive epidemiology of Carbapenem-resistant Enterobacteriaceae (CRE) in 4 hospitals of large healthcare system in Miami.•Prevalence and incidence rates increased from 2012 to 2014 and declined from 2015 to 2016.•Infection prevention interventions contributed to control increasing CRE rates.•Screening cultures of intensive care unit patients enabled early detection of cases.•An internal electronic registry system allowed rapid identification of readmissions.
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.
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.
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.
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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32334004</pmid><doi>10.1016/j.ajic.2020.04.013</doi><tpages>7</tpages></addata></record> |
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| subjects | Active surveillance testing, Infection prevention and control Bacterial Carbapenemase producing Enterobacteriaceae Carbapenems Drug Resistance Multidrug resistant organisms registry Multiple South Florida |
| title | Epidemiology of carbapenem-resistant Enterobacteriaceae in hospitals of a large healthcare system in Miami, Florida from 2012 to 2016: Five years of experience with an internal registry |
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