Faster screening benefits patients and cuts costs
We are testing a new strategy for screening carriers of multi-resistant gut bacteria in hospitals. This strategy will accelerate decisions on patients’ treatment and on whether or not they need to be put into isolation.
Project description (ongoing research project)
Gut bacteria that are resistant to a large number of antibiotics due to their ability to produce special antibiotic-degrading enzymes such as ESBL and/or carbapenemases cause a substantial financial burden for hospitals. Affected patients are often identified too late or kept in isolation too long due to false alerts. We are therefore developing a faster screening strategy using the LAMP test pretested at the University of Geneva Hospitals, which is capable of rapidly identifying the most common multi-resistant gut bacteria. The LAMP test is supplemented by a new molecular test that specifically identifies the virulent, antibiotic-resistant E. coli strain ST 131. To assess its effectiveness, we will test the strategy over a period of 12 months and compare the results with conventional screening.
Current diagnostic methods for detecting ESBL- and carbapenemase-producing gut bacteria are based on bacterial cultures. However, these tests need at least 48 hours to produce test results, which delays the decision on appropriate treatment and infection control measures. Furthermore, existing tests do not accurately identify subtypes of antibiotic-resistant Escherichia coli. New methods, such as the ones used in this project, already exist, but their clinical and economic relevance has not yet been investigated.
The aim is to compare the new screening strategy, which is based on rapid diagnostic tools, with current practice. The results should provide clear conclusions about clinical relevance and cost-efficiency.
If the strategy produces the desired results, it will benefit many patients as well as saving costs. It is simple to apply to everyday clinical practice and could therefore be implemented quickly.
An interventional study to evaluate the impact of a rapid screening strategy in improving nosocomial ESBL and CPE control in critically ill patients