• Gershengorn, Hayley
• Arenas, Sebastian
• Warde, Prem
• Ferreira, Tanira
• Parekh, Dipen J.
• Zhou, Yi
• Tamrakar, Labu
• Pagan, Paola P.
• Shukla, Bhavarth S.
• Seely, Spencer
• Patel, Samira

Abstract

<jats:title>Abstract</jats:title><jats:sec id="S2732494X2300445X_as1"><jats:title>Objective:</jats:title><jats:p>Assess turnaround time (TAT) and cost-benefit of on-site <jats:italic>C. auris</jats:italic> screening and its impact on length of stay (LOS) and costs compared to reference laboratories.</jats:p></jats:sec><jats:sec id="S2732494X2300445X_as2"><jats:title>Design:</jats:title><jats:p>Before-and-after retrospective cohort study.</jats:p></jats:sec><jats:sec id="S2732494X2300445X_as3"><jats:title>Setting:</jats:title><jats:p>Large-tertiary medical center.</jats:p></jats:sec><jats:sec id="S2732494X2300445X_as4"><jats:title>Methods:</jats:title><jats:p>We validated an on-site polymerase chain reaction-based testing platform for <jats:italic>C. auris</jats:italic> and retrospectively reviewed hospitalized adults who screened negative before and after platform implementation. We constructed multivariable models to assess the association of screening negative with hospital LOS/cost in the pre and postimplementation periods. We adjusted for confounders such as demographics and indwelling device use, and compared TATs for all samples tested.</jats:p></jats:sec><jats:sec id="S2732494X2300445X_as5"><jats:title>Results:</jats:title><jats:p>The sensitivity and specificity of the testing platform were 100% and 98.11%, respectively, compared to send-out testing. The clinical cohort included 287 adults in the pre and 1,266 postimplementation period. The TAT was reduced by more than 2 days (3 (interquartile range (IQR): 2.0, 7.0) vs 0.42 (IQR: 0.24, 0.81), <jats:italic>p</jats:italic> &lt; 0.001). Median LOS was significantly lower in the postimplementation period; however, this was no longer evident after adjustment. In relation to total cost, the time period had an effect of $6,965 (95% CI: −$481, $14,412); <jats:italic>p</jats:italic> = 0.067) on reducing the cost. The median adjusted total cost per patient was $7,045 (IQR: $3,805, $13,924) less in the post vs the preimplementation period.</jats:p></jats:sec><jats:sec id="S2732494X2300445X_as6"><jats:title>Conclusions:</jats:title><jats:p>Our assessment did not find a statistically significant change in LOS, nevertheless, on-site testing was not cost-prohibitive for the institution. The value of on-site testing may be supported if an institutional <jats:italic>C. auris</jats:italic> reduction strategy emphasizes faster TATs.</jats:p></jats:sec>

Topics

• laser emission spectroscopy
• size-exclusion chromatography
• chemical ionisation