Dr Rebecca Sparks1, Dr Ruchir Chavada1
1Liverpool Hospital, Liverpool, Australia
Biography:
Dr Rebecca Sparks is a final year Infectious Diseases and microbiology trainee at Liverpool Hospital in Sydney. She has research interests workflow optimisation, diagnostic and antimicrobial stewardship, antimicrobial resistance, organisms of emerging significance and the prevention and control of infectious diseases.
Abstract:
Introduction
Carbapenemase producing Enterobacterales (CPE) are an emerging cause of healthcare associated infection. The Clinical Excellence Commission (CEC) have developed a guideline to assist with prevention and containment of CPE in healthcare facilities. The aim of the study was to assess the compliance to the guideline and determine the potential barriers for decreased compliance.
Methods
This is a retrospective cohort study conducted at a single tertiary centre from June 2022 to April 2024. We reviewed cases where CPE were isolated from either clinical or infection control screening samples. Index cases and contacts (as defined by the CEC guideline) were included in the study. Data was collected on CPE contact screening and clearance as per CEC guideline.
Results
There were 27 CPE index cases that triggered contact tracing investigation, with 138 cases identified as contacts requiring screening. There was one case with microbiological confirmation of CPE transmission and one case where a genotypically different CPE was identified. 43 (31%) contacts completed all required CPE screening samples with 42 (30%) achieving clearance from CPE precautions. Cases discharged by the time of CPE confirmation in the laboratory was the main reason for not achieving clearance compliance. Time to laboratory confirmation of CPE and confirmation of CPE cases during non-business hours were contributing factor.
Conclusion
In our cohort CPE contact screening identified one additional linked CPE case and one unlinked case although only one third of confirmed contacts completed screening. Compliance with the guideline was poor when a contact was discharged from the facility.