From: Rapid detection of glycopeptide-resistant enterococci: impact on decision-making and costs
Investigation of the first case in the diabetology unit | Investigation of a secondary case in the nephrology unit | |
---|---|---|
(n=31 patients) | (n=22 patients) | |
Test Results, n (%) | ||
Cepheid Xpert™ van A/van B assay: | ||
Negative PCR | 1 (3)a | 17 (77) |
Positive van A | 1 (3)a | 0 (0) |
Positive van B and culture showing susceptible strain | - | 2 (9) |
PCR invalid then negative culture | - | 2 (9) |
PCR invalid then culture showing susceptible stain | - | 1 (5) |
Culture after enrichment using chromogenic medium: | ||
Negative culture | 26 (84) | - |
Culture positive for GRE strainb | 1 (3)a | - |
Culture positive for susceptible Enterococcusc | 4 (13) | - |
Turn-around time (hours, median [Q1-Q3]) | ||
From sampling, to sample reception | 2.6 (1.7-2.6) | 2.8 (1.1 – 3.8) |
From sample reception, to inoculation or preparation | 2.3 (2.2– 2.4) | 1.3 (0.5 – 2.3) |
From inoculation or preparation, to results | 65.5 (65.5– 65.5) | 1 (0.9-1.1) |
From sample reception, to results | 67.8 (68.4 – 67.9) | 6.22 (3.7 – 8.2) |
From sampling, to results | 70.5 (69.4 – 70.5) | 4.6 (4.0 – 18.9) |
Maximal time to obtain all results | 70.5 | 90.0 |
Cost of microbiological analysis (€) | ||
Cepheid Xpert™ van A/van B assay: | ||
Cost of 1 cartridge | - | 35.60 |
Cost of 1 test | - | 37.30 |
Culture with chromogenic medium and enrichment | ||
Cost of a negative culture | 4.80 | - |
Cost of a doubtful culturec | 13.40 | - |
Cost of a doubtful cultured | 23.50 | - |
Cost of a positive cultureb | 117.80 | - |
Total cost of microbiological testing | 333.50 | 870.40 |
Loss of income | ||
Cost per weighted case per day in 2011e | 340.70 | 426.00 |
Scenario 1: Implementation of local guidelines | ||
Patient-days lost f | 41 | 0 |
Estimated loss of income (€) | 13,968.70 | 0 |
Scenario 2: Implementation of national guidelines | ||
Patient-days lostf | 250 | 0 |
Estimated loss of income (€) | 85,175.00 | 0 |
Overall loss of income (€) | 13,968.70 to 85,175.00 | 0 |
Overall cost of the strategy (€) | 14,302.20 to 86,175.50g | 870.40 to 2,611.20g |