University of Louisville Hospital Influenced by AHRQ Toolkit to Detect Antibiotic-Resistant Infections

Patient Safety
December 2015

The University of Louisville Hospital in Louisville, Kentucky, was influenced by an AHRQ toolkit to adopt strategies that more quickly and accurately track a dangerous healthcare-associated infection (HAI).

The toolkit, Carbapenem-Resistant Enterobacteriaceae (CRE) Control and Prevention Toolkit, helped the hospital implement a gene test that can detect and track CRE and other multi-drug resistant organisms using molecular genetic techniques and bioinformatics. The gene test was developed by OpGen, a Gaithersburg, Maryland-based company that relies on AHRQ's CRE toolkit to implement pilot studies aimed at reducing HAIs. Molecular genetic testing is faster and more comprehensive than traditional microbe detection methods based on culturing specimens—a process that can take days.

AHRQ's CRE toolkit "is a playbook, a great game plan" for health care facilities to better understand and begin CRE screening efforts, said Michael Farmer, ‎marketing director at OpGen. "The toolkit was a strong impetus for implementing our pilot programs, and it is front and center among the tools we share to assist in implementation."

The AHRQ toolkit provides hospitals with multiple approaches to reduce CRE, including increasing facility leaders' role in prevention and control efforts, as well as methods for getting clinical staff to incorporate screening into daily routines.

"We didn't know if we had CRE in the hospital," said Forest W. Arnold, D.O., M.Sc., University of Louisville Hospital epidemiologist. The hospital tested 214 patients in November 2014 as part of the pilot program and found that two patients had CRE and 24 others were found to have a pathogen resistant to vancomycin, a common antibiotic.

"It only takes one patient to have an outbreak," said Dr. Arnold. None of the patients died, but the results prompted the hospital to re-evaluate its screening practices.

OpGen's gene test identified multi-drug resistant organism threats early and led the University of Louisville Hospital to "isolate infected patients or those who are carriers before uninfected patients could be exposed," Dr. Arnold explained, noting that "AHRQ's toolkit helped direct our pilot study at the hospital."

The toolkit, he concluded, helps "organizations understand why screening is needed... and how they can develop an effective plan to address antimicrobial resistance with our solutions and the expert guidance published by AHRQ."

Impact Case Study Identifier: 
AHRQ Product(s): CRE Toolkit, Publications
Topics(s): Patient Safety, Healthcare-Associated Infections (HAIs)
Geographic Location: Kentucky
Implementer: University of Louisville Hospital
Date: 12/16/2015
Page last reviewed December 2015
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