ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2017
Cost-effectiveness analysis of universal screening for carbapenemase-producing Enterobacteriaceae in hospital inpatients.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 52 citations in OpenAlex.
- Costs-effectiveness and cost components of pharmaceutical and non-pharmaceutical interventions affecting antibiotic resistance outcomes in hospital patients: a systematic literature review.BMJ global health · 2024Pooled it
- Implementation of wastewater-based epidemiology in a Northern California acute care hospital: a pilot study, June-July 2024.The Journal of hospital infection · 2026Article
- An Economic Model to Assess the Cost Impact of Using Xpert Carba-R to Screen Carbapenemase-Producing Enterobacterales in Comparison with Standard of Care, in a National Health Service Setting.Infectious diseases and therapy · 2025Article
- Review
- Epidemiology of Carbapenemase-Producing Enterobacterales Carriage in a Paediatric Tertiary Health Care Centre of Ontario, Canada.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2024Article
- Model-based evaluation of admission screening strategies for the detection and control of carbapenemase-producing Enterobacterales in the English hospital setting.BMC medicine · 2023Article
- The impact of enhanced screening for carbapenemase-producing Enterobacterales in an acute care hospital in South Korea.Antimicrobial resistance and infection control · 2023Article
- Surveillance and Stewardship: Where Infection Prevention and Antimicrobial Stewardship Intersect.Open forum infectious diseases · 2023Article
- Observational
- Decrease in Mortality from Sepsis: Impact of the Multidisciplinary Program for the Hematologic Patient at Very High Risk.Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion · 2023Article
- Cost-effectiveness of strategies to control the spread of carbapenemase-producing Enterobacterales in hospitals: a modelling study.Antimicrobial resistance and infection control · 2022Article
- Transmission of gram-negative antibiotic-resistant bacteria following differing exposure to antibiotic-resistance reservoirs in a rural community: a modelling study for bloodstream infections.Scientific reports · 2022Article
- Economic Evaluation of Nemonoxacin, Moxifloxacin and Levofloxacin in the Treatment of Early Community-Acquired Pneumonia with Possible Pulmonary Tuberculosis.International journal of environmental research and public health · 2022Article
- A Data-Driven Framework for Identifying Intensive Care Unit Admissions Colonized With Multidrug-Resistant Organisms.Frontiers in public health · 2022Article
- Global Threat of Carbapenem-Resistant Gram-Negative Bacteria.Frontiers in cellular and infection microbiology · 2022Review
- Household Transmission of Carbapenemase-producing Enterobacterales in Ontario, Canada.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Learning from pragmatic local research.Infection prevention in practice · 2021Article
- Carbapenemase-producing organism (CPO) colonisation at a district general hospital: universal screening may help reduce transmission.Infection prevention in practice · 2021Article
- The value of decreasing the duration of the infectious period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.PLoS computational biology · 2021Article
- Carbapenemase screening in an Irish tertiary referral hospital: Best practice, or can we do better?Infection prevention in practice · 2020Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The purpose of this study was to assess the cost-effectiveness of screening all hospital inpatients for carbapenemase-producing Enterobacteriaceae (CPE) at the time of hospital admission, compared to not screening, from a US hospital perspective. We used a linked transmission/Markov model to compare outcomes for a typical hospitalized medical patient, from a community with a colonization prevalence of 0.05%. Outcomes were number of colonized patients, CPE-related clinical infections and deaths, expected quality-adjusted life years (QALYs), cost, and the incremental cost-effectiveness ratio (ICER). Sensitivity analyses were performed to assess the effect of parameter uncertainty, using a willingness-to-pay threshold of $100,000 per QALY gained. Screening prevented six CPE colonization cases per 1000 patients (1/1000 colonized with screening, 7/1000 without screening), over half of all symptomatic CPE infections (2/10,000 symptomatic with screening, 5/10,000 symptomatic without screening), and nearly half of all CPE-related deaths (8/100,000 deaths with screening, 15/100,000 deaths without screening). Screening accrued 0.0009 additional QALYs and cost an additional $24.68, compared to not screening, and was cost-effective (ICER $26,283 per QALY gained). Our results were sensitive to uncertainty in prevalence and the number of secondary colonizations per colonized patient. Screening was not cost-effective at a prevalence below 0.015% or if transmission to fewer than 0.9 new patients occurred for each colonized patient. At prevalence levels above 0.3%, screening was cost-saving compared to not screening. Screening inpatients for CPE carriage is likely cost-effective, and may be cost-saving, depending on the local prevalence of carriage.
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Registered trials
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