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. 2001 Mar-Apr;7(2):306–311. doi: 10.3201/eid0702.010233

New technology for detecting multidrug-resistant pathogens in the clinical microbiology laboratory.

L R Peterson 1, G A Noskin 1
PMCID: PMC2631739  PMID: 11294730

Abstract

Northwestern Memorial Hospital instituted in-house molecular typing to rapidly assess microbial clonality and integrated this typing into an infection control program. We compared data on nosocomial infections collected during 24 months before and 60 months after implementing the new program. During the intervention period, infections per 1,000 patient-days fell 13% (p=0.002) and the percentage of hospitalized patients with nosocomial infections decreased 23% (p=0.000006). In our hospital, the percentage of patients with nosocomial infections is 43% below the U.S. rate. Our typing laboratory costs approximately $400,000 per year, a savings of $5.00 for each dollar spent.

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Selected References

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  1. Archibald L. K., Gaynes R. P. Hospital-acquired infections in the United States. The importance of interhospital comparisons. Infect Dis Clin North Am. 1997 Jun;11(2):245–255. doi: 10.1016/s0891-5520(05)70354-8. [DOI] [PubMed] [Google Scholar]
  2. Bodnar U. R., Noskin G. A., Suriano T., Cooper I., Reisberg B. E., Peterson L. R. Use of in-house studies of molecular epidemiology and full species identification for controlling spread of vancomycin-resistant Enterococcus faecalis isolates. J Clin Microbiol. 1996 Sep;34(9):2129–2132. doi: 10.1128/jcm.34.9.2129-2132.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bonten M. J., Hayden M. K., Nathan C., van Voorhis J., Matushek M., Slaughter S., Rice T., Weinstein R. A. Epidemiology of colonisation of patients and environment with vancomycin-resistant enterococci. Lancet. 1996 Dec 14;348(9042):1615–1619. doi: 10.1016/S0140-6736(96)02331-8. [DOI] [PubMed] [Google Scholar]
  4. Check W. A. Cracking the cases of infection clusters. CAP Today. 1996 May;10(5):1, 14-6, 18-21 passim. [PubMed] [Google Scholar]
  5. Clabots C. R., Johnson S., Bettin K. M., Mathie P. A., Mulligan M. E., Schaberg D. R., Peterson L. R., Gerding D. N. Development of a rapid and efficient restriction endonuclease analysis typing system for Clostridium difficile and correlation with other typing systems. J Clin Microbiol. 1993 Jul;31(7):1870–1875. doi: 10.1128/jcm.31.7.1870-1875.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Emori T. G., Culver D. H., Horan T. C., Jarvis W. R., White J. W., Olson D. R., Banerjee S., Edwards J. R., Martone W. J., Gaynes R. P. National nosocomial infections surveillance system (NNIS): description of surveillance methods. Am J Infect Control. 1991 Feb;19(1):19–35. doi: 10.1016/0196-6553(91)90157-8. [DOI] [PubMed] [Google Scholar]
  7. Emori T. G., Gaynes R. P. An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev. 1993 Oct;6(4):428–442. doi: 10.1128/cmr.6.4.428. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Fang F. C., McClelland M., Guiney D. G., Jackson M. M., Hartstein A. I., Morthland V. H., Davis C. E., McPherson D. C., Welsh J. Value of molecular epidemiologic analysis in a nosocomial methicillin-resistant Staphylococcus aureus outbreak. JAMA. 1993 Sep 15;270(11):1323–1328. [PubMed] [Google Scholar]
  9. Hacek D. M., Suriano T., Noskin G. A., Kruszynski J., Reisberg B., Peterson L. R. Medical and economic benefit of a comprehensive infection control program that includes routine determination of microbial clonality. Am J Clin Pathol. 1999 May;111(5):647–654. doi: 10.1093/ajcp/111.5.647. [DOI] [PubMed] [Google Scholar]
  10. Haley R. W., Culver D. H., White J. W., Morgan W. M., Emori T. G. The nationwide nosocomial infection rate. A new need for vital statistics. Am J Epidemiol. 1985 Feb;121(2):159–167. doi: 10.1093/oxfordjournals.aje.a113988. [DOI] [PubMed] [Google Scholar]
  11. Haley R. W., White J. W., Culver D. H., Hughes J. M. The financial incentive for hospitals to prevent nosocomial infections under the prospective payment system. An empirical determination from a nationally representative sample. JAMA. 1987 Mar 27;257(12):1611–1614. [PubMed] [Google Scholar]
  12. Jarvis W. R. Selected aspects of the socioeconomic impact of nosocomial infections: morbidity, mortality, cost, and prevention. Infect Control Hosp Epidemiol. 1996 Aug;17(8):552–557. doi: 10.1086/647371. [DOI] [PubMed] [Google Scholar]
  13. Keita-Perse O., Gaynes R. P. Severity of illness scoring systems to adjust nosocomial infection rates: a review and commentary. Am J Infect Control. 1996 Dec;24(6):429–434. doi: 10.1016/s0196-6553(96)90036-x. [DOI] [PubMed] [Google Scholar]
  14. Lupski J. R. Molecular epidemiology and its clinical application. JAMA. 1993 Sep 15;270(11):1363–1364. [PubMed] [Google Scholar]
  15. Noskin G. A., Cooper I., Peterson L. R. Vancomycin-resistant Enterococcus faecium sepsis following persistent colonization. Arch Intern Med. 1995 Jul 10;155(13):1445–1447. [PubMed] [Google Scholar]
  16. Noskin G. A., Lee J., Hacek D. M., Postelnick M., Reisberg B. E., Stosor V., Weitzman S. A., Peterson L. R. Molecular typing for investigating an outbreak of Candida krusei. Diagn Microbiol Infect Dis. 1996 Nov-Dec;26(3-4):117–123. doi: 10.1016/s0732-8893(96)00204-0. [DOI] [PubMed] [Google Scholar]
  17. O'Brien T. F. The global epidemic nature of antimicrobial resistance and the need to monitor and manage it locally. Clin Infect Dis. 1997 Jan;24 (Suppl 1):S2–S8. doi: 10.1093/clinids/24.supplement_1.s2. [DOI] [PubMed] [Google Scholar]
  18. Peterson L. R., Petzel R. A., Clabots C. R., Fasching C. E., Gerding D. N. Medical technologists using molecular epidemiology as part of the infection control team. Diagn Microbiol Infect Dis. 1993 May-Jun;16(4):303–311. doi: 10.1016/0732-8893(93)90080-q. [DOI] [PubMed] [Google Scholar]
  19. Pfaller M. A., Herwaldt L. A. The clinical microbiology laboratory and infection control: emerging pathogens, antimicrobial resistance, and new technology. Clin Infect Dis. 1997 Oct;25(4):858–870. doi: 10.1086/515557. [DOI] [PubMed] [Google Scholar]
  20. Samore M., Killgore G., Johnson S., Goodman R., Shim J., Venkataraman L., Sambol S., DeGirolami P., Tenover F., Arbeit R. Multicenter typing comparison of sporadic and outbreak Clostridium difficile isolates from geographically diverse hospitals. J Infect Dis. 1997 Nov;176(5):1233–1238. doi: 10.1086/514117. [DOI] [PubMed] [Google Scholar]
  21. Savor C., Pfaller M. A., Kruszynski J. A., Hollis R. J., Noskin G. A., Peterson L. R. Comparison of genomic methods for differentiating strains of Enterococcus faecium: assessment using clinical epidemiologic data. J Clin Microbiol. 1998 Nov;36(11):3327–3331. doi: 10.1128/jcm.36.11.3327-3331.1998. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Scheckler W. E., Brimhall D., Buck A. S., Farr B. M., Friedman C., Garibaldi R. A., Gross P. A., Harris J. A., Hierholzer W. J., Jr, Martone W. J. Requirements for infrastructure and essential activities of infection control and epidemiology in hospitals: A consensus panel report. Society for Healthcare Epidemiology of America. Am J Infect Control. 1998 Feb;26(1):47–60. doi: 10.1016/s0196-6553(98)70061-6. [DOI] [PubMed] [Google Scholar]
  23. Schiappa D. A., Hayden M. K., Matushek M. G., Hashemi F. N., Sullivan J., Smith K. Y., Miyashiro D., Quinn J. P., Weinstein R. A., Trenholme G. M. Ceftazidime-resistant Klebsiella pneumoniae and Escherichia coli bloodstream infection: a case-control and molecular epidemiologic investigation. J Infect Dis. 1996 Sep;174(3):529–536. doi: 10.1093/infdis/174.3.529. [DOI] [PubMed] [Google Scholar]
  24. Schifman R. B., Howanitz P. J. Nosocomial infections. A college of American pathologists Q-probes study in 512 North American institutions. Arch Pathol Lab Med. 1994 Feb;118(2):115–119. [PubMed] [Google Scholar]
  25. Stosor V., Kruszynski J., Suriano T., Noskin G. A., Peterson L. R. Molecular epidemiology of vancomycin-resistant enterococci: a 2-year perspective. Infect Control Hosp Epidemiol. 1999 Oct;20(10):653–659. doi: 10.1086/501560. [DOI] [PubMed] [Google Scholar]
  26. Wilson M. P., Spencer R. C. Laboratory role in the management of hospital acquired infections. J Hosp Infect. 1999 May;42(1):1–6. doi: 10.1053/jhin.1998.0545. [DOI] [PubMed] [Google Scholar]

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