PMID- 37490485
OWN - NLM
STAT- MEDLINE
DCOM- 20231024
LR  - 20231024
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 18
IP  - 7
DP  - 2023
TI  - Universal screening or a universal risk assessment combined with risk-based 
      screening for multidrug-resistant microorganisms upon admission: Comparing 
      strategies.
PG  - e0289163
LID - 10.1371/journal.pone.0289163 [doi]
LID - e0289163
AB  - OBJECTIVE: 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. METHODS: 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. RESULTS: 
      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<0.001). Of the 37 carriers identified through the 
      universal screening, 35 (94.6%) reported no risk factors. CONCLUSIONS: Our 
      results show that in our low endemic setting, a universal screening strategy 
      identified significantly more MDRO carriers than the currently implemented 
      universal risk-assessment. When implementing a universal risk-assessment, risk 
      factors should be carefully selected to be able to identify ESBL-E carriers. 
      While the universal screening identified more MDRO carriers, further research is 
      needed to determine the cost-effectiveness of this strategy.
CI  - Copyright: (c) 2023 van der Schoor et al. This is an open access article 
      distributed under the terms of the Creative Commons Attribution License, which 
      permits unrestricted use, distribution, and reproduction in any medium, provided 
      the original author and source are credited.
FAU - van der Schoor, Adrienne S
AU  - van der Schoor AS
AD  - Department of Medical Microbiology and Infectious Diseases, Erasmus MC University 
      Medical Center, Rotterdam, The Netherlands.
FAU - Severin, Juliette A
AU  - Severin JA
AD  - Department of Medical Microbiology and Infectious Diseases, Erasmus MC University 
      Medical Center, Rotterdam, The Netherlands.
FAU - Klaassen, Corne H W
AU  - Klaassen CHW
AD  - Department of Medical Microbiology and Infectious Diseases, Erasmus MC University 
      Medical Center, Rotterdam, The Netherlands.
FAU - van den Akker, Johannes P C
AU  - van den Akker JPC
AD  - Department of Adult Intensive Care, Erasmus MC University Medical Center, 
      Rotterdam, The Netherlands.
FAU - Bruno, Marco J
AU  - Bruno MJ
AD  - Department of Gastroenterology and Hepatology, Erasmus MC University Medical 
      Center, Rotterdam, The Netherlands.
FAU - Hendriks, Johanna M
AU  - Hendriks JM
AD  - Department of Surgery, Erasmus MC University Medical Center, Rotterdam, The 
      Netherlands.
FAU - Vos, Margreet C
AU  - Vos MC
AD  - Department of Medical Microbiology and Infectious Diseases, Erasmus MC University 
      Medical Center, Rotterdam, The Netherlands.
FAU - Voor In 't Holt, Anne F
AU  - Voor In 't Holt AF
AUID- ORCID: 0000-0002-3560-1725
AD  - Department of Medical Microbiology and Infectious Diseases, Erasmus MC University 
      Medical Center, Rotterdam, The Netherlands.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20230725
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Risk Assessment
MH  - *Drug Resistance, Multiple
MH  - Patient Admission
MH  - Prospective Studies
MH  - Humans
MH  - Male
MH  - Female
MH  - Adolescent
MH  - Young Adult
MH  - Adult
MH  - Middle Aged
MH  - Aged
MH  - Aged, 80 and over
PMC - PMC10368271
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/07/25 19:15
MHDA- 2023/07/27 06:43
PMCR- 2023/07/25
CRDT- 2023/07/25 13:43
PHST- 2023/03/14 00:00 [received]
PHST- 2023/07/12 00:00 [accepted]
PHST- 2023/07/27 06:43 [medline]
PHST- 2023/07/25 19:15 [pubmed]
PHST- 2023/07/25 13:43 [entrez]
PHST- 2023/07/25 00:00 [pmc-release]
AID - PONE-D-23-07434 [pii]
AID - 10.1371/journal.pone.0289163 [doi]
PST - epublish
SO  - PLoS One. 2023 Jul 25;18(7):e0289163. doi: 10.1371/journal.pone.0289163. 
      eCollection 2023.