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- DOI 10.18231/j.ijirm.38687.1759221499
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CrossMark
Carbapenem-resistant enterobacteriaceae (CRE) Screening from rectal swabs in ICU patients
- Author Details:
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Rachana Patel
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Nancy Krishnakant Javiya
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Tanuja Javadekar
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Amit Pravin Chauhan
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Bhavinkumar Bhagubhai Patel
Rachana Patel
Nancy Krishnakant Javiya
Amit Pravin Chauhan
Bhavinkumar Bhagubhai Patel
Background: Carbapenem-Resistant Enterobacteriaceae (CRE) are an emerging threat in healthcare settings, particularly in intensive care units (ICUs), where patients are at higher risk of colonization and infection. Early detection of CRE carriers is essential for enforcing infection control measures and preventing the spread of infection.
Objective: To evaluate the effectiveness, feasibility, and cost-benefit ratio of implementing a systematic CRE screening program using rectal swabs for patients admitted to ICUs.
Materials and Methods: This observational study was conducted in the Central Microbiology Laboratory of Dhiraj Hospital, Vadodara, Gujarat, India. Rectal swabs were collected from ICU patients within 24 hours of admission and weekly thereafter. Rectal swabs were collected from 80 patients and processed according to the Centers for Disease Control and Prevention (CDC) protocol for CRE detection. Samples were processed using culture-based methods. Statistical analysis assessed colonization rates, subsequent infection rates, and the impact of early detection on transmission dynamics.
Results: Among 80 ICU patients screened, the overall CRE colonization rate at admission was 10%. An additional 3.75% of patients developed CRE during their ICU stay. Early identification and isolation of CRE-colonized patients was associated with a 62% reduction in nosocomial CRE transmission compared to historical controls. The sensitivity and specificity of culture-based methods were 87.4% and 99.1%, respectively.
Conclusion: Implementation of universal CRE screening with rectal swabs in ICU settings is a feasible and effective strategy for early detection of colonized patients. The screening program demonstrated a favourable cost-benefit ratio when considering prevented infections and associated healthcare costs.