Cheap and slow (culture) is usually better than fast and expensive (PCR) for CPE screening: Bertha says so!

BMC Medicine has published some research from our group reporting the findings of a mathematical model comparing various approaches to screening for CPE carriage. The model compared how several operational metrics varied with different approaches to screening (‘slow and cheap’ laboratory culture vs. ‘fast and expensive’ PCR) and in various specialties with variable levels of compliance with CPE admission screening and at various levels of admission prevalence of CPE. The main conclusion was that culture proved to be the best approach in most scenarios, balancing risk and resource.

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Evaluating the value of multidisciplinary reviews to get to the root causes of C. difficile infection

An interesting paper has been published evaluating the cost and value of multidisciplinary team (MDT) meetings to investigate C. difficile cases. The study counts the cost of C. difficile MDTs (somewhere between £25k and £50k over two years), and concludes that they had limited value in delivering additional learning or quality improvement. But I beg to differ…!

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Counting the cost of CPE Mk II

Earlier this year, CMI published our article on the cost of a CPE outbreak in London, which cost 1.1m (Euros) over 10 months. EID have recently published a similar article, reporting a 0.6m (Euro) outbreak of CPE in the Netherlands.

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Effective stewardship: less antibiotic use and more hand hygiene

Rossana Rosa (bio below) writes a guest post, reflecting on this recent review and meta-analysis on the effectiveness of antimicrobial stewardship (AMS) programmes…

The first reports on the effects of Antimicrobial Stewardship Programmess date back to the mid-90s, and the interest in them has taken off in the past decade.

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A health economist’s guide to the AMS galaxy

Guest blogger Nikki Naylor (bio below) has written this post about a recent review on the cost-effectiveness of antimicrobial stewardship…

I’ll start this blog post off with a promise – I promise not to use any equations or unnecessarily complex terms that just describe logical concepts (something us economists do like to do on occasion). In return, I hope that you will see past the standard and not-to-exhilarating conclusion of “more evidence is needed” and see some of the more useful messages that sit within this recent review that we have published.

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CPE screening Q&A: the who, when, and how

I gave a talk yesterday as part of a PHE London event on the whys and wherefores of screening for MDROs – my talk was focussed on CPE, and you can download my slides here: “CPE: seek and ye shall find”. I thought a quick Q&A would be the best way to summarise the content.

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Need to save some money? Then universal admission screening for CPE is for you!

Many guidelines now recommend screening some patients on admission for carriage of CPE. However, very few cost-effectiveness analyses have been performed. A Canadian group have just published a modelling study with a tantalising conclusion: universal admission screening for CPE is likely to be cost-effective, and may even be cost-saving!

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