729. I Can CPO Clearing Now, the Iso is Gone

BACKGROUND: There is little research or guidance about clearing patients who are colonized with carbapenemase-producing organisms (CPO). The use of isolation precautions to reduce transmission needs to be balanced with the potential negative impacts of isolation on patient experience, quality of care and non-infection patient safety and outcome measures. Our objective was to develop and implement a standardized provincial protocol for clearing patients of their CPO-positive status. METHODS: PubMed, Web of Science, EMBASE and Cochrane Library were searched from January 2000 to February 2023. Randomized control trials, retrospective and prospective cohort studies, cross-sectional studies and case series were included. This information was used to create a CPO clearing protocol for use by Alberta Health Services (AHS) Infection Prevention and Control (IPC). The protocol will be monitored through the provincial surveillance system (ProvSurv) to guide future changes. RESULTS: The literature showed that although CPO colonization can be prolonged (more than 12 months), a significant number of patients tested CPO-negative by 3 months since the last positive test. In addition, one-third of patients with 1 or 2 negative swabs subsequently tested CPO-positive. Therefore, the proposed provincial guidance is to re-screen patients 3 months after their last CPO-positive result. Three negative sets (without antibiotic pressure) done at least one week apart are required to clear a CPO flag; where a negative set includes a rectal swab or stool culture, cultures of previously positive sites if still clinically relevant, and additional currently relevant sites. CONCLUSION: This project aimed to create a standardized provincial protocol for clearing patients of their CPO-positive status to decrease the duration of isolation, while also balancing resource management and patient-centred care. After implementation, next steps include evaluation by monitoring compliance and examining specific CPO-related indicators. There is potential for use by other healthcare institutions and organizations. DISCLOSURES: All Authors: No reported disclosures