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Operational impact of decreased turnaround times for Candida auris screening tests in a tertiary academic medical center
OBJECTIVE: Assess turnaround time (TAT) and cost-benefit of on-site C. auris screening and its impact on length of stay (LOS) and costs compared to reference laboratories. DESIGN: Before-and-after retrospective cohort study. SETTING: Large-tertiary medical center. METHODS: We validated an on-site po...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cambridge University Press
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644160/ https://www.ncbi.nlm.nih.gov/pubmed/38028904 http://dx.doi.org/10.1017/ash.2023.445 |
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author | Arenas, Sebastian Patel, Samira Seely, Spencer O. Pagan, Paola P. Warde, Prem R. Tamrakar, Labu J. Parekh, Dipen J. Ferreira, Tanira Zhou, Yi Gershengorn, Hayley B. Shukla, Bhavarth S. |
author_facet | Arenas, Sebastian Patel, Samira Seely, Spencer O. Pagan, Paola P. Warde, Prem R. Tamrakar, Labu J. Parekh, Dipen J. Ferreira, Tanira Zhou, Yi Gershengorn, Hayley B. Shukla, Bhavarth S. |
author_sort | Arenas, Sebastian |
collection | PubMed |
description | OBJECTIVE: Assess turnaround time (TAT) and cost-benefit of on-site C. auris screening and its impact on length of stay (LOS) and costs compared to reference laboratories. DESIGN: Before-and-after retrospective cohort study. SETTING: Large-tertiary medical center. METHODS: We validated an on-site polymerase chain reaction-based testing platform for C. auris 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. RESULTS: 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), p < 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); p = 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. CONCLUSIONS: 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 C. auris reduction strategy emphasizes faster TATs. |
format | Online Article Text |
id | pubmed-10644160 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cambridge University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-106441602023-10-18 Operational impact of decreased turnaround times for Candida auris screening tests in a tertiary academic medical center Arenas, Sebastian Patel, Samira Seely, Spencer O. Pagan, Paola P. Warde, Prem R. Tamrakar, Labu J. Parekh, Dipen J. Ferreira, Tanira Zhou, Yi Gershengorn, Hayley B. Shukla, Bhavarth S. Antimicrob Steward Healthc Epidemiol Original Article OBJECTIVE: Assess turnaround time (TAT) and cost-benefit of on-site C. auris screening and its impact on length of stay (LOS) and costs compared to reference laboratories. DESIGN: Before-and-after retrospective cohort study. SETTING: Large-tertiary medical center. METHODS: We validated an on-site polymerase chain reaction-based testing platform for C. auris 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. RESULTS: 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), p < 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); p = 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. CONCLUSIONS: 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 C. auris reduction strategy emphasizes faster TATs. Cambridge University Press 2023-10-18 /pmc/articles/PMC10644160/ /pubmed/38028904 http://dx.doi.org/10.1017/ash.2023.445 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited. |
spellingShingle | Original Article Arenas, Sebastian Patel, Samira Seely, Spencer O. Pagan, Paola P. Warde, Prem R. Tamrakar, Labu J. Parekh, Dipen J. Ferreira, Tanira Zhou, Yi Gershengorn, Hayley B. Shukla, Bhavarth S. Operational impact of decreased turnaround times for Candida auris screening tests in a tertiary academic medical center |
title | Operational impact of decreased turnaround times for Candida auris screening tests in a tertiary academic medical center |
title_full | Operational impact of decreased turnaround times for Candida auris screening tests in a tertiary academic medical center |
title_fullStr | Operational impact of decreased turnaround times for Candida auris screening tests in a tertiary academic medical center |
title_full_unstemmed | Operational impact of decreased turnaround times for Candida auris screening tests in a tertiary academic medical center |
title_short | Operational impact of decreased turnaround times for Candida auris screening tests in a tertiary academic medical center |
title_sort | operational impact of decreased turnaround times for candida auris screening tests in a tertiary academic medical center |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10644160/ https://www.ncbi.nlm.nih.gov/pubmed/38028904 http://dx.doi.org/10.1017/ash.2023.445 |
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