Patient selection for screening:
(1) from long-term acute care facility to hospital
(2) from hospital to long-term care facility
Outcome: positive surveillance culture for a carbapenem-resistant Enterobacteriaceae
Parameters:
(1) Charlson comorbidity score
(2) immunosuppression
(3) indwelling devices (central vascular catheters, external drains, urinary catheters, external fixators, tracheostomy tube, gastrostomy tube)
(4) prior antibiotic exposure
|
Parameters
|
Findings
|
Points
|
|
Charlson comorbidity score
|
0 to 3
|
0
|
|
|
> 3
|
1 (OR 4.9)
|
|
immunosuppression
|
absent
|
0
|
|
|
present
|
1 (OR 3.9)
|
|
indwelling device
|
absent
|
0
|
|
|
present
|
1 (OR 5.2)
|
|
prior antibiotic exposure
|
absent
|
0
|
|
|
present
|
1 (OR 3.9)
|
total number of risk factors =
= SUM(points for all 4 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 4
• The risk of colonization increases with the number of risk factors present.
• The prevalence of carbapenem-resistant organisms in the community, the hospital and the LCAT will affect the pre-test probability.
