The associated impact of standardized admission screening on vancomycin-resistant Enterococci bloodstream infections

Infect Control Hosp Epidemiol. 2023 Aug;44(8):1289-1293. doi: 10.1017/ice.2022.239. Epub 2022 Oct 6.

Abstract

Objective: To determine whether discontinuing active screening for vancomycin-resistant Enterococcus (VRE) in Alberta, Canada, acute-care facilities had an associated impact on the rate of rise of hospital-acquired (HA) VRE bloodstream infection (VRE-BSI).

Setting: Acute-care facilities in Alberta, Canada.

Patients: All patients who were admitted to Alberta Health Services or Covenant Health acute-care facilities between January 1, 2013, and March 31, 2020, and who met the definition for hospital-acquired VRE-BSI were included in the analyses.

Methods: An intervention time-series Poisson regression was used to determine the slope change in VRE incidence between the pre- and postintervention (screening) periods. The patient population was separated into 3 cohorts: group 1 (low risk, VRE screening stopped), group 2 (high risk, VRE screening stopped), and group 3 (high risk, VRE screening continued). For all groups, a level- and slope-change model was used.

Results: We did not find a statistically significant difference in the slope change or rate of rise in VRE-BSI before and after the intervention, with incidence rate ratio (IRRs) of 1.015 (95% confidence interval [CI], 0.982-1.049), 1.025 (95% CI, 0.967-1.086), and 0.989 (95% CI, 0.924-1.059) for groups 1, 2 and 3, respectively.

Conclusions: In Alberta, the rate of HA VRE-BSI has remained consistent, and our findings indicate that there has been no increase in the rate of rise of HA VRE-BSI in sites or units that discontinued screening for VRE, regardless of patient risk group.

MeSH terms

  • Alberta / epidemiology
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia* / diagnosis
  • Bacteremia* / drug therapy
  • Bacteremia* / epidemiology
  • Gram-Positive Bacterial Infections* / diagnosis
  • Gram-Positive Bacterial Infections* / drug therapy
  • Gram-Positive Bacterial Infections* / epidemiology
  • Humans
  • Retrospective Studies
  • Vancomycin
  • Vancomycin-Resistant Enterococci*

Substances

  • Anti-Bacterial Agents
  • Vancomycin