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Brian Milner

903.360.9291

Jeani Smith

409.504.8032

Senior Care Partners

Solutions For Success

Antibiotic resistance has become a serious and ever evolving global healthcare threat that should be addressed when patients are entering the healthcare system; providing a front-line for the influx of patients in the identification and protection against antibiotic gene resistance. It is critical that members of the Infection Control and Prevention Team acquire data regarding high risk patients entering the facility as soon as possible. When a significant infection risk or gene resistance mechanism is identified, SOP’s to effectively manage these patients and help prevent the spread of antibiotic resistant bacteria is imperative to meet both clinical and financial outcome goals.

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"A STRONG CASE CAN BE MADE TO PROPERLY IDENTIFY AND MANAGE PATIENTS ENTERING " HIGH-RISK [HEALTHCARE] ENVIRONMENT FOR PREEXISTING INFECTION OR BEING COLONIZED FOR GENES THAT CODE FOR ANTIBIOTIC RESISTANCE (INFECTED OR NOT)."

Patients who are at risk of carrying antibiotic gene resistance at the time of admission often have identifiable risk factors which include:

  • Multidrug-resistant organism (MDRO) colonization or infection within the past year

  • Chronic hemodialysis

  • Long-term care facility/hospital transfer

  • Exposure to two or more antibiotics within the previous 30 days

  • Patient > 60 years with chronic health problems; particularly chronic obstructive pulmonary disease (COPD)

  • Peritonitis

  • ABSSSI (Acute Bacterial Skin and Skin Structure Infection)

High-Risk Symptomatic Patients

Identification of antibiotic-resistance genes of those patients who present to the ED, or enter post treatment facilities such as LTACs and SNFs with symptoms of infection, and who are in a high-risk group as noted above, is central to meeting core measures. Carefully collected specimens that are representative of the infectious process should be used to determine the presence of multidrug-resistant organisms.

Patients who are symptomatic with no particular focus of infections, such as fever of unknown origin, can be screened for an antibiotic resistance mechanism using a carefully collected rectal swab. Patients who are colonized with bacteria that carry a gene that codes for antibiotic resistance typically shed these organisms via the alimentary tract. Therefore, a careful sampling of the mucosal surface of the lower sigmoid colon is ideal to identify carriers of antibiotic-resistant bacteria.

  • RESULTS AVAILABLE NEXT DAY

  • TESTS PERFORMED UTILIZING QUANTITATIVE REAL-TIME PCR (qPCR)

  • GREATER THAN 99% SENSITIVITY & SPECIFICITY

  • RESULTS UNAFFECTED BY CURRENT OR RECENT ANTIBIOTIC USE

  • ANTIBIOTIC RESISTANCE DETECTION

  • PHARM D GUIDANCE BASED ON THE RESULTS OF MOLECULAR PATHOLOGY REPORT AND DETECTION OF ANTIBIOTIC RESISTANCE MECHANISMS

"A COMPREHENSIVE APPROACH TO SCREEN FOR MDRO'S COULD BE A USEFUL PART OF AN EFFECTIVE ANTIBIOTIC STEWARDSHIP PROGRAM.”

Antimicrobial Stewardship Program leaders should routinely receive reports of antibiotic resistance screening as a means of improving infection control, confirming antibiotic resistance trends from retrospective antibiogram report data, and provide a metric for overall program monitoring.

Estimates regarding the medical cost per patient with an antibiotic-resistant infection range from $18,588 to $29,069. The total economic burden placed on the U.S. economy by antibiotic-resistant infections has been estimated to be as high as $20 billion in health care costs and $35 billion a year in lost productivity.

"THE DURATION OF HOSPITAL STAYS FOR PATIENTS WITH ANTIBIOTIC-RESISTANT INFECTIONS WAS FOUND TO BE PROLONGED BY 6.4 TO 12.7 DAYS, COLLECTIVELY ADDING AN EXTRA EIGHT MILLION HOSPITAL DAYS."

~National Center for Biotechnology Information

The Final Cost To Healthcare