Universal screening or a universal risk assessment combined with risk-based screening for multidrug-resistant microorganisms upon admission: Comparing strategies

• Published in: PloS one 2023-07, Vol.18 (7), p.e0289163-e0289163
• Main Authors: van der Schoor, Adriënne S, Severin, Juliëtte A, Klaassen, Corné H W, van den Akker, Johannes P C, Bruno, Marco J, Hendriks, Johanna M, Vos, Margreet C, Voor In 't Holt, Anne F
• Format: Article
• Language: English
• Subjects: Beta lactamases; Biology and life sciences; Care and treatment; Cohort analysis; Computer and Information Sciences; Cross infection; Current carriers; Diagnosis; Drug resistance in microorganisms; Electronic health records; Electronic medical records; Evaluation; Health aspects; Health risks; Hospitals; Informed consent; Medical records; Medical screening; Medicine and Health Sciences; Methicillin; Microorganisms; Multidrug resistance; Multidrug resistant organisms; Nosocomial infection; Nosocomial infections; Observational studies; Patients; Risk assessment; Risk factors; Staphylococcus infections; Strategy; β Lactamase
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0289163

Timely identification of patients who carry multidrug-resistant microorganisms (MDRO) is needed to prevent nosocomial spread to other patients and to the hospital environment. We aimed to compare the yield of a universal screening strategy upon admission to the currently installed universal risk assessment combined with risk-based screening upon admission. This observational study was conducted within a prospective cohort study. From January 1, 2018, until September 1, 2019, patients admitted to our hospital were asked to participate. Nasal and perianal samples were taken upon admission and checked for the presence of MDRO. The results of the universal risk assessment and risk-based screening were collected retrospectively from electronic health records. In total, 1017 patients with 1069 separate hospital admissions participated in the study. Universal screening identified 38 (3.6%) unknown MDRO carriers upon admission (37 individual patients), all carrying extended-spectrum beta-lactamase-producing Enterobacterales. For 946 of 1069 (88.5%) patients, both the universal risk assessment and universal screening were performed. For 19 (2.0%) admissions, ≥1 risk factor was identified. The universal risk assessment identified one (0.1%) unknown carrier, compared to 37 out of 946 carriers for the universal screening (P