An interventional quasi-experimental study to evaluate the impact of a rapid screening strategy in improving control of nosocomial extended-spectrum beta-lactamase-producing Enterobacterales and carbapenemase-producing organisms in critically ill patients

Table 2 Individual and aggregated characteristics of study participants and ICU patients

Among participants screened at admissions	Interventional period	Control period	p value
Among participants screened at admissions	n = 147 patients^a	N = 86 patients^a	p value
Patients at a high risk (%)	30 (20.4%)	29 (33.7%)	0.04
Median length of stay (days, IQR)	2.8 (1.5–5.6)	2.8 (1.7–7.1)	0.67
nEcESBL-PE carriers	10 (6.8%)	8 (9.3%)	0.68
CPO carriers	1 (0.7%)	3 (3.5%)	0.14
CPE carriers	1 (0.7%)	3 (3.5%)	0.14
Preemptive contact precautions prescribed	115 (78.2%)	70 (81.4%)	0.45

Among all participants screened weekly	n = 589 patients^b	n = 313 patients^b	p value
Median length of stay (days, IQR)^c	6.9 (2.9–12.6)	6.9 (3.8–15.1)	0.06
nEcESBL-PE carriers	19 (3.2%)	16 (5.1%)	0.22
CPO carriers	4 (0.7%)	8 (2.6%)	0.03
CPE carriers	3 (0.5%)	3 (1.0%)	0.42
Newly detected carriers	13 (2.2%)	10 (3.2%)	0.52
Contact precautions implemented at the time of detection among newly detected carriers	1/13 (7.7%)	6/10 (60%)	0.02

Colonization pressure (incidence density)	n = 8884 patient-days	n = 3772 patients-days	p value
ESBL-PE (cases per 1000 patient-days)	15.3 [95% CI 12.8–18.1]	19.1 [95% CI 14.9–24.0]	0.13
CPO (cases per 1000 patient-days)	0.7 [95% CI 0.2–1.5]	2.9 [95% CI 1.5–5.2]	0.05
CPE (cases per 1000 patient-days)	0.4 [95% CI 0.1–1.1]	1.6 [95% CI 0.6–3.5]	0.22

Antibiotic consumption (ATC JC01)	n = 8884 patient-days	n = 3772 patients-days	p value
Aminoglycoside (median DDD/1000 patient-days)	19.2 [95% CI 8.2–26.8]	22.5 [95% CI 18.3–29.5]	0.44
Carbapenems (median DDD/1000 patient-days)	97.0 [95% CI 66.9–129.0]	126.0 [95% CI 104.0–133.0]	0.18
Piperacillin and beta-lactamase inhibitor (median DDD/1000 patient-days)	145.0 [95% CI 128.0–168.0]	114.0 [95% CI 96.1–128.0]	0.03

Hand hygiene compliance among healthcare workers	Hand hygiene opportunities = 474	Hand hygiene opportunities = 360	p value
Pooled mean of hand hygiene compliance	59.7 [95% CI 55.3–64.1]	61.1 [95% CI 56.1–66.1]	0.73

^aTwo patients screened at admission were readmitted during the control phase.
^bSix patients stayed both in the interventional and control phase.
^cInformation available for 151 and 312 patients in the interventional and control period.

ISSN: 1364-8535