26 / 150
challenged on poor practice. Environmental sampling did not reveal a
source.
Results:
No more cases for 15 months.
Discussion and/or Conclusion(s):
15 months since outbreak,
enhanced surveillance and discussion at trust wide Lessons Learnt
forum has helped sustain changes in practice and reduce cross-
infection on ICU.
ID: 4877
Counting the cost of controlling an outbreak of carbapenemase-
producing Enterobacteriaceae: an economic evaluation
Jon Otter
1
, Philip Burgess
2
, Frances Davies
1
, Siddharth Mookerjee
1
,
Julie Singleton
1
, Mark Gilchrist
1
, Darren Parsons
1
, Eimear Brannigan
1
,
Julie Robotham
3
, Alison Holmes
1
.
1
Imperial College NHS Healthcare
Trust,
2
Department of Health,
3
PHE
Background:
Carbapenemase-producing Enterobacteriaceae (CPE)
are an emerging threat to healthcare facilities worldwide.
Aim(s)/Objective(s):
To perform an economic evaluation on the cost
associated with containing an outbreak of CPE.
Method(s):
An outbreak affecting 40 patients with NDM-producing
Klebsiella pneumoniae
CPE occurred in a group of 5 hospitals across 3
sites in London between March and December 2015. Costs associated
with the outbreak were split into actual expenditure, and
‘
opportunity
cost
’
(sub-divided into increased staffing time, missed revenue-
generating procedures, and the cost of extended length of stay).
Costs are accounted from the hospital perspective. Interventions
contributing to the cost included enhanced CPE screening, drug costs,
staff time, contact precautions (isolation), ward/bay/bed closures,
temporary ward-based monitors of hand and environmental practice,
environmental decontamination, estates renovations, and elective
surgical missed revenue.
Results:
The management of the outbreak cost a total of £1,303,721
over 10 months, comprising £498,258 of actual expenditure, and
£805,463 in opportunity cost. The opportunity cost comprised:
£319,756 related to lost bed days, £295,704 in missed revenue from
elective surgical procedures, and £190,003 in staff time. Lost bed days
accrued the most cost, followed by cancelled elective surgical
procedures. The opportunity costs were notably greater than the
actual expenditure.
Discussion and/or Conclusion(s):
NHS hospitals have experienced
CPE outbreaks and the cost estimates that we present show that a local,
regional or national emergence of CPE could be highly costly for the
NHS. This highlights the serious nature and high cost of antimicrobial
resistance.
Abstracts of FIS/HIS 2016
–
Oral Presentations / Journal of Hospital Infection 94S1 (2016) S11
–
S21
S21