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Hello to my Australian colleagues,
We have recently experienced a CRE outbreak involving 4 patients that was not associated with any overseas hospitalisation or travel . A laboratory colleague who recently attend a conference in Melbourne advises that it is the norm now in Australian acute hospitals to screen all patients who have travelled overseas for CPO/CRE as per the ACSQH 2013 guidelines for CRE. We are coming under pressure to introduce this.
We currently screen all patients who have had an overseas hospital stay within the previous 12 months but if we were to screen all travellers as well, we would not be able to isolate them pending screening results and I am not sure how cost effective the screening would be versus positive results.I am interested to know if most Australian acute hospitals actually do this extended screening and if so how you were able to get buy in from the nursing staff.
Cheers
Ruth
[IPC logo for email signature]
Ruth Barratt RN, BSc, MAdvPrac (Hons)
Clinical NurseSpecialist Infection Prevention and Control
Community Liaison Infection Prevention
*: ruth.barratt@cdhb.health.nz
*: + 64 3 3640 083 or ext.80083
[1098272744j4O36h]: 0275 263175
Level 5, Riverside Building
Christchurch Hospital | Private Bag 4710, Christchurch
Clean Hands Save Lives!********************************************************************************************
Check out our web site: http://www.cdhb.health.nz
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Ruth
The Victorian Guidelines for CPE released in December 2015 state the following patients require pre-emptive isolation & screening on admission to a health service:
* Direct transfer from an overseas hospital
* Overnight stay in an overseas hospital or residential care facility in previous 12 months
* A room contact of a CPE case who has not achieved criteria for being ‘cleared’
* A ward contact of a CPE case from a transmission risk area who has not achieved criteria for being ‘cleared’
The guidelines can be found at: https://www2.health.vic.gov.au/about/publications/policiesandguidelines/carbapenemase-producing-enterobacteriaceae-guidelines
Regards
JudyJudith Brett | Infection Control Consultant
VICNISS Coordinating Centre
Doherty Institute | Level 2
792 Elizabeth St, Melbourne, Victoria 3000
T: + 61 3 9342 9353 | F: + 61 3 9342 9355 | judy.brett@mh.org.au
T: + 61 3 9342 9333 (Reception)
W: http://www.vicniss.org.au[cid:image001.jpg@01D17A01.ABFCEA50][cid:image002.png@01D17A01.ABFCEA50]
Hello to my Australian colleagues,
We have recently experienced a CRE outbreak involving 4 patients that was not associated with any overseas hospitalisation or travel . A laboratory colleague who recently attend a conference in Melbourne advises that it is the norm now in Australian acute hospitals to screen all patients who have travelled overseas for CPO/CRE as per the ACSQH 2013 guidelines for CRE. We are coming under pressure to introduce this.
We currently screen all patients who have had an overseas hospital stay within the previous 12 months but if we were to screen all travellers as well, we would not be able to isolate them pending screening results and I am not sure how cost effective the screening would be versus positive results.I am interested to know if most Australian acute hospitals actually do this extended screening and if so how you were able to get buy in from the nursing staff.
Cheers
Ruth
[cid:image001.jpg@01D17A08.FAEABD70]
Ruth Barratt RN, BSc, MAdvPrac (Hons)
Clinical NurseSpecialist Infection Prevention and Control
Community Liaison Infection Prevention
:: ruth.barratt@cdhb.health.nz
(: + 64 3 3640 083 or ext.80083
[cid:image002.jpg@01D17A08.FAEABD70]: 0275 263175
Level 5, Riverside Building
Christchurch Hospital | Private Bag 4710, Christchurch
Clean Hands Save Lives!********************************************************************************************
Check out our web site: http://www.cdhb.health.nz
This email and attachments have been scanned for content and viruses and is believed to be clean This email or attachments may contain confidential or legally privileged information intended for the sole use of the addressee(s). Any use, redistribution, disclosure, or reproduction of this message, except as intended, is prohibited. If you received this email in error, please notify the sender and remove all copies of the message, including any attachments. Any views or opinions expressed in this email (unless otherwise stated) may not represent those of Canterbury District Health Board
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Hi Ruth,
It actually isn’t a requirement in either the 2013 ACSQHC CRE guideline (http://www.safetyandquality.gov.au/wp-content/uploads/2013/12/MRGN-Guide-Enterobacteriaceae-PDF-1.89MB.pdf ) or the recently released Victorian guideline on carbapenemase-producing Enterobacteriaceae (https://www2.health.vic.gov.au/public-health/infectious-diseases/infection-control-guidelines/carbapenemase-producing-enterobacteriaceae-management) to screen all patients for CRE/CPE with a recent travel history only. The recommendation is, as you appear to already be doing, to screen all patients directly transferred from overseas hospitals and all patients who have had an overnight admission to a hospital or residential care facility in the previous 12 months.
The ACSQHC CRE guideline is in the process of being updated and should be released soon, but I am not aware that the screening requirements will change to include anyone who has travelled overseas in the previous 12 months.
I am also not aware of any hospitals in Victoria that would be undertaking this level of screening as they would also not have the ability to pre-emptively isolate that many patients until cleared either (and it also not required by the Vic CPE guideline). It is a huge undertaking to attempt to screen all patients who have a recent overseas travel history. If they really want to go down that path then it would be better to risk assess which countries present the greatest risk of acquiring CPE from just travelling to them and/or choose which hospital admissions it is more relevant to (e.g. pre TRUS biopsies etc).
Regards,
Donna
………………………………………………………………………..
Donna Cameron | Infection Control Consultant
Microbiological Diagnostic Unit
Public Health Laboratory | Department of Microbiology & Immunology
The University of Melbourne, Building 248, Level 1, 792 Elizabeth Street, Melbourne, 3010, VIC
Telephone +61 3 8344 3574 | Fax +61 3 8344 7833
Website http://www.mduphl.unimelb.edu.au/
[cid:image001.jpg@01D0A504.C7427D20]
This email and any attachments may contain personal information or information that is otherwise confidential or the subject of copyright. Any use, disclosure or copying of any part of it is prohibited. The University does not warrant that this email or any attachments are free from viruses or defects. Please check any attachments for viruses and defects before opening them. If this email is received in error please delete it and notify us by return email.Hello to my Australian colleagues,
We have recently experienced a CRE outbreak involving 4 patients that was not associated with any overseas hospitalisation or travel . A laboratory colleague who recently attend a conference in Melbourne advises that it is the norm now in Australian acute hospitals to screen all patients who have travelled overseas for CPO/CRE as per the ACSQH 2013 guidelines for CRE. We are coming under pressure to introduce this.
We currently screen all patients who have had an overseas hospital stay within the previous 12 months but if we were to screen all travellers as well, we would not be able to isolate them pending screening results and I am not sure how cost effective the screening would be versus positive results.I am interested to know if most Australian acute hospitals actually do this extended screening and if so how you were able to get buy in from the nursing staff.
Cheers
Ruth
[IPC logo for email signature]
Ruth Barratt RN, BSc, MAdvPrac (Hons)
Clinical NurseSpecialist Infection Prevention and Control
Community Liaison Infection Prevention
*: ruth.barratt@cdhb.health.nz
*: + 64 3 3640 083 or ext.80083
[1098272744j4O36h]: 0275 263175
Level 5, Riverside Building
Christchurch Hospital | Private Bag 4710, Christchurch
Clean Hands Save Lives!********************************************************************************************
Check out our web site: http://www.cdhb.health.nz
This email and attachments have been scanned for content and viruses and is believed to be clean This email or attachments may contain confidential or legally privileged information intended for the sole use of the addressee(s). Any use, redistribution, disclosure, or reproduction of this message, except as intended, is prohibited. If you received this email in error, please notify the sender and remove all copies of the message, including any attachments. Any views or opinions expressed in this email (unless otherwise stated) may not represent those of Canterbury District Health Board
********************************************************************************************
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Hi,
In HK, we conduct Adm. Screening for CRE, if patient has been hospitalized outside HK in the last 6 months (e.g. UK, USA, China, India …etc).
Regards,
Sony SO
Nursing Officer, Infection Control Team
CND WTSH
office phone: +852 3517-3676; fax: +852 3517-3520
HA email sony@ha.org.hk
Please consider the environment before printing this e-mailHello to my Australian colleagues,
We have recently experienced a CRE outbreak involving 4 patients that was not associated with any overseas hospitalisation or travel . A laboratory colleague who recently attend a conference in Melbourne advises that it is the norm now in Australian acute hospitals to screen all patients who have travelled overseas for CPO/CRE as per the ACSQH 2013 guidelines for CRE. We are coming under pressure to introduce this.
We currently screen all patients who have had an overseas hospital stay within the previous 12 months but if we were to screen all travellers as well, we would not be able to isolate them pending screening results and I am not sure how cost effective the screening would be versus positive results.I am interested to know if most Australian acute hospitals actually do this extended screening and if so how you were able to get buy in from the nursing staff.
Cheers
Ruth
[cid:image001.jpg@01D17A08.FAEABD70]
Ruth Barratt RN, BSc, MAdvPrac (Hons)
Clinical NurseSpecialist Infection Prevention and Control
Community Liaison Infection Prevention
*: ruth.barratt@cdhb.health.nz
*: + 64 3 3640 083 or ext.80083
[cid:image002.jpg@01D17A08.FAEABD70]: 0275 263175
Level 5, Riverside Building
Christchurch Hospital | Private Bag 4710, Christchurch
Clean Hands Save Lives!********************************************************************************************
Check out our web site: http://www.cdhb.health.nz
This email and attachments have been scanned for content and viruses and is believed to be clean This email or attachments may contain confidential or legally privileged information intended for the sole use of the addressee(s). Any use, redistribution, disclosure, or reproduction of this message, except as intended, is prohibited. If you received this email in error, please notify the sender and remove all copies of the message, including any attachments. Any views or opinions expressed in this email (unless otherwise stated) may not represent those of Canterbury District Health Board
********************************************************************************************
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Hi Ruth,
Find attached the recently released Victorian Department of Health guideline
on “Carbapenemase-producing Enterobacteriaceae” which were released on
December 2015. This document may be useful as it is more detailed than the
“ACSQH 2013 guidelines for CRE” which is currently being updated/reviewed.Available at:
https://www2.health.vic.gov.au/public-health/infectious-diseases/infection-c
ontrol-guidelinesVICNISS organised an education seminar (19/2/2016) to describe and provide
helpful advice on the implementation of these guidelines at the local level
across Victorian hospitals – see link to speaker presentationshttps://www.vicniss.org.au/news-and-updates/cpe-education-seminar/
My impression from this seminar was that most hospital where doing their
best to implement the Victorian strategies as outlined in the guidelines.Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
M: +61 404 816 434
ABN 47533508426
Of Ruth Barratt
CPO/CREHello to my Australian colleagues,
We have recently experienced a CRE outbreak involving 4 patients that was
not associated with any overseas hospitalisation or travel . A laboratory
colleague who recently attend a conference in Melbourne advises that it is
the norm now in Australian acute hospitals to screen all patients who have
travelled overseas for CPO/CRE as per the ACSQH 2013 guidelines for CRE. We
are coming under pressure to introduce this.We currently screen all patients who have had an overseas hospital stay
within the previous 12 months but if we were to screen all travellers as
well, we would not be able to isolate them pending screening results and I
am not sure how cost effective the screening would be versus positive
results.I am interested to know if most Australian acute hospitals actually do this
extended screening and if so how you were able to get buy in from the
nursing staff.Cheers
Ruth
IPC logo for email signature
Ruth Barratt RN, BSc, MAdvPrac (Hons)
Clinical NurseSpecialist Infection Prevention and Control
Community Liaison Infection Prevention
:: ruth.barratt@cdhb.health.nz
(: + 64 3 3640 083 or ext.80083
1098272744j4O36h: 0275 263175
Level 5, Riverside Building
Christchurch Hospital | Private Bag 4710, Christchurch
Clean Hands Save Lives!
****************************************************************************
****************
Check out our web site: http://www.cdhb.health.nz
This email and attachments have been scanned for content and viruses and is
believed to be clean This email or attachments may contain confidential or
legally privileged information intended for the sole use of the
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including any attachments. Any views or opinions expressed in this email
(unless otherwise stated) may not represent those of Canterbury District
Health Board
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the quotes) to listserv@aicalist.org.auMESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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Hi Ruth,
This is very timely question and one we would like to clarify too.
We recently had a patient who wasn’t a direct transfer from an overseas hospital but was admitted a few days after their return and CRE was isolated on an admission wound swab.
The other concern we have are for our CFAT patients, many of them are not direct admissions from a hospital but we assume they have had recent hospitalisation. They are not routinely swabbed for MROs on admission as they are not always known or flagged to IPC at this time. We are working with our IT department to ensure they are flagged at the beginning of their admission so at least we get a base line. We have had request from the facilities that the patients are returning to, to swab for MRSA, VRE. What are other facilities doing?
Kind regards
JayneJayne OConnor RN, BSc.Inf.Cont.
IPC Co ordinator
Sydney Adventist Hospital
185 Fox valley Rd,
Wahroonga 2076Hello to my Australian colleagues,
We have recently experienced a CRE outbreak involving 4 patients that was not associated with any overseas hospitalisation or travel . A laboratory colleague who recently attend a conference in Melbourne advises that it is the norm now in Australian acute hospitals to screen all patients who have travelled overseas for CPO/CRE as per the ACSQH 2013 guidelines for CRE. We are coming under pressure to introduce this.
We currently screen all patients who have had an overseas hospital stay within the previous 12 months but if we were to screen all travellers as well, we would not be able to isolate them pending screening results and I am not sure how cost effective the screening would be versus positive results.I am interested to know if most Australian acute hospitals actually do this extended screening and if so how you were able to get buy in from the nursing staff.
Cheers
Ruth
[IPC logo for email signature]
Ruth Barratt RN, BSc, MAdvPrac (Hons)
Clinical NurseSpecialist Infection Prevention and Control
Community Liaison Infection Prevention
*: ruth.barratt@cdhb.health.nz
*: + 64 3 3640 083 or ext.80083
[1098272744j4O36h]: 0275 263175
Level 5, Riverside Building
Christchurch Hospital | Private Bag 4710, Christchurch
Clean Hands Save Lives!********************************************************************************************
Check out our web site: http://www.cdhb.health.nz
This email and attachments have been scanned for content and viruses and is believed to be clean This email or attachments may contain confidential or legally privileged information intended for the sole use of the addressee(s). Any use, redistribution, disclosure, or reproduction of this message, except as intended, is prohibited. If you received this email in error, please notify the sender and remove all copies of the message, including any attachments. Any views or opinions expressed in this email (unless otherwise stated) may not represent those of Canterbury District Health Board
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Dear All,
Further to Donnas suggestion below for those looking for more information on
transrectal ultrasonography (TRUS)-guided biopsy find attached the following
Australian review published in 2014.. Grummet et al 2014 BJU International – Sepsis and superbug:
should we favour the transperineal over transrectal approach for prostate
biopsyRegards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
M: +61 404 816 434
ABN 47533508426
Of Donna Cameron
CPO/CREHi Ruth,
It actually isn’t a requirement in either the 2013 ACSQHC CRE guideline
(http://www.safetyandquality.gov.au/wp-content/uploads/2013/12/MRGN-Guide-En
terobacteriaceae-PDF-1.89MB.pdf ) or the recently released Victorian
guideline on carbapenemase-producing Enterobacteriaceae
(https://www2.health.vic.gov.au/public-health/infectious-diseases/infection-
control-guidelines/carbapenemase-producing-enterobacteriaceae-management) to
screen all patients for CRE/CPE with a recent travel history only. The
recommendation is, as you appear to already be doing, to screen all patients
directly transferred from overseas hospitals and all patients who have had
an overnight admission to a hospital or residential care facility in the
previous 12 months.The ACSQHC CRE guideline is in the process of being updated and should be
released soon, but I am not aware that the screening requirements will
change to include anyone who has travelled overseas in the previous 12
months.I am also not aware of any hospitals in Victoria that would be undertaking
this level of screening as they would also not have the ability to
pre-emptively isolate that many patients until cleared either (and it also
not required by the Vic CPE guideline). It is a huge undertaking to attempt
to screen all patients who have a recent overseas travel history. If they
really want to go down that path then it would be better to risk assess
which countries present the greatest risk of acquiring CPE from just
travelling to them and/or choose which hospital admissions it is more
relevant to (e.g. pre TRUS biopsies etc).Regards,
Donna
………………………………………………………………….
…….
Donna Cameron | Infection Control ConsultantMicrobiological Diagnostic Unit
Public Health Laboratory | Department of Microbiology & Immunology
The University of Melbourne, Building 248, Level 1, 792 Elizabeth Street,
Melbourne, 3010, VIC
Telephone +61 3 8344 3574 | Fax +61 3 8344 7833
Website
http://www.mduphl.unimelb.edu.au/cid:image001.jpg@01D0A504.C7427D20
This email and any attachments may contain personal information or
information that is otherwise confidential or the subject of copyright. Any
use, disclosure or copying of any part of it is prohibited. The University
does not warrant that this email or any attachments are free from viruses or
defects. Please check any attachments for viruses and defects before opening
them. If this email is received in error please delete it and notify us by
return email.Of Ruth Barratt
Hello to my Australian colleagues,
We have recently experienced a CRE outbreak involving 4 patients that was
not associated with any overseas hospitalisation or travel . A laboratory
colleague who recently attend a conference in Melbourne advises that it is
the norm now in Australian acute hospitals to screen all patients who have
travelled overseas for CPO/CRE as per the ACSQH 2013 guidelines for CRE. We
are coming under pressure to introduce this.We currently screen all patients who have had an overseas hospital stay
within the previous 12 months but if we were to screen all travellers as
well, we would not be able to isolate them pending screening results and I
am not sure how cost effective the screening would be versus positive
results.I am interested to know if most Australian acute hospitals actually do this
extended screening and if so how you were able to get buy in from the
nursing staff.Cheers
Ruth
IPC logo for email signature
Ruth Barratt RN, BSc, MAdvPrac (Hons)
Clinical NurseSpecialist Infection Prevention and Control
Community Liaison Infection Prevention
:: ruth.barratt@cdhb.health.nz
(: + 64 3 3640 083 or ext.80083
1098272744j4O36h: 0275 263175
Level 5, Riverside Building
Christchurch Hospital | Private Bag 4710, Christchurch
Clean Hands Save Lives!
****************************************************************************
****************
Check out our web site: http://www.cdhb.health.nz
This email and attachments have been scanned for content and viruses and is
believed to be clean This email or attachments may contain confidential or
legally privileged information intended for the sole use of the
addressee(s). Any use, redistribution, disclosure, or reproduction of this
message, except as intended, is prohibited. If you received this email in
error, please notify the sender and remove all copies of the message,
including any attachments. Any views or opinions expressed in this email
(unless otherwise stated) may not represent those of Canterbury District
Health Board
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the quotes) to listserv@aicalist.org.auMESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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