ArticleAntimicrobial resistance and infection control2023
The impact of enhanced screening for carbapenemase-producing Enterobacterales in an acute care hospital in South Korea.
Article in Antimicrobial resistance and infection control, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 12 citations in OpenAlex.
- Incidence and factors associated with carbapenem-resistant Enterobacterales infection among hospitalized internal medicine patients in Korea: a retrospective observational study.Journal of Korean biological nursing science · 2026Article
- Outbreak investigation and genomic analysis reveal hidden transmission networks of KPC-2-producing Enterobacterales in a South Korean hospital.Antimicrobial resistance and infection control · 2026Article
- Early prediction of colonization by carbapenemase-producing enterobacterales at ICU admission using machine learning.Scientific reports · 2026Article
- Diagnostic performance of the direct stool Xpert Carba-R assay in active surveillance of carbapenemase-producing enterobacterales.Antimicrobial resistance and infection control · 2025Article
- The evolving epidemiology of Carbapenemase-producing Enterobacterales in Canadian acute care facilities, 2010-2023.Antimicrobial resistance and infection control · 2025Article
- An outbreak of blaAntimicrobial resistance and infection control · 2024Article
- Risk Factors and Outcomes of Patients Colonized with KPC and NDM Carbapenemase-Producing Enterobacterales.Antibiotics (Basel, Switzerland) · 2024Article
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6 authors at 2 institutions in 3 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundCarbapenemase-producing Enterobacterales (CPE) poses a significant challenge to infection control in healthcare settings. Active screening is recommended to prevent intra-hospital CPE transmission.
methodsCPE screening was initiated at a 660-bed hospital in South Korea in September 2018, targeting patients previously colonized/infected or admitted to outside healthcare facilities (HCFs) within 1 month. Universal intensive care unit (ICU) screening was performed at the time of admission. After a hospital-wide CPE outbreak in July-September 2019, the screening program was enhanced by extending the indications (admission to any HCF within 6 months, receipt of hemodialysis) with weekly screening of ICU patients. The initial screening method was changed from screening cultures to the Xpert Carba-R assay. The impact was assessed by comparing the CPE incidence per 1000 admissions before (phase 1, September 2018-August 2019) and after instituting the enhanced screening program (phase 2, September 2019-December 2020).
resultsA total of 13,962 (2,149 and 11,813 in each phase) were screened as indicated, among 49,490 inpatients, and monthly screening compliance increased from 18.3 to 93.5%. Compared to phase 1, the incidence of screening positive patients increased from 1.2 to 2.3 per 1,000 admissions (P = 0.005) during phase 2. The incidence of newly detected CPE patients was similar (3.1 vs. 3.4, P = 0.613) between two phases, but the incidence of hospital-onset CPE patients decreased (1.9 vs. 1.1, P = 0.018). A significant decrease was observed (0.5 to 0.1, P = 0.014) in the incidence of patients who first confirmed CPE positive through clinical cultures without a preceding positive screening. Compared to phase 1, the median exposure duration and number of CPE contacts were also markedly reduced in phase 2: 10.8 days vs. 1 day (P < 0.001) and 11 contacts vs. 1 contact (P < 0.001), respectively. During phase 2, 42 additional patients were identified by extending the admission screening indications (n = 30) and weekly in-ICU screening (n = 12).
conclusionsThe enhanced screening program enabled us to identify previously unrecognized CPE patients in a rapid manner and curtailed a hospital-wide CPE outbreak. As CPE prevalence increases, risk factors for CPE colonization can broaden, and hospital prevention strategies should be tailored to the changing local CPE epidemiology.
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