Evaluation of a New Point-of-use Faucet Filter for Preventing Legionella and Total Bacterial Exposure

studies have shown carriage rates lasting well past one year, poor clinical outcomes for patients that become infected with CRE, as demonstrated by 50% mortality among bacteremic cases. Currently in Michigan, there is no mandatory reporting requirement and our CRE prevalence remains unknown. This study worked collaboratively to determine the CRE prevalence in West Michigan. METHODS: A CRE study team was assembled consisting of microbiologists, infection preventionists and epidemiologists. The participating units were from six hospitals/facilities that included: adult Intensive Care Units (ICUs), Long Term Care (LTC), Long Term Acute Care (LTAC), geriatric units, skilled nursing, and rehab. A random sample of eligible patients were approached for their consent to the study. A single peri-rectal swab was collected and transported to our microbiology department to be screened. All positive Results were sent to the state lab for confirmatory testing. Chart review was conducted to evaluate underlying medical conditions as well as antibiotic exposure. RESULTS: Over the study, 53 patients from 8 units from 6 hospitals/ facilities were enrolled. Two positive CREs were confirmed in Klebseilla pneumonia and Enterobacter cloacae. Our point prevalence was 3.8%. The mean agewas 67 years. In the previous 90 days, 66% had been in acute care, 62% in LTC, and 21% in LTAC. Twenty-six percent had recent history of Multiple Drug-Resistant Organisms (MDROs). One third of patients had a urinary catheter and ventilators in place at time of specimen collection. Vancomycin was the most common antibiotic therapy, 25% at time of collection and 34% in the last 90 days. CONCLUSIONS: This study demonstrated a CRE prevalence of nearly 4%. The two positive CRE patients had previous MDRO history, but no history of CRE. Conversely, there was one known CRE positive patient, who screened negative during this study. This study demonstrates both intermittent and unknown CRE colonization in high risk patients and emphasizes the need for identification, appropriate isolation, and antibiotic stewardship in order to limit transmission and keep the prevalence of CRE low.