?url_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&rft.relation=http%3A%2F%2Fd-scholarship-dev.library.pitt.edu%2F34105%2F&rft.title=Multidrug-resistant+organisms+(MDRO)%3A+cost-effective+analysis+of+horizontal+vs.+vertical+surveillance&rft.creator=Schmitz%2C+Emily%2FJ&rft.description=Introduction%3A+Multidrug-resistant+organisms+(MDRO)+are+still+a+serious+public+health+problem+in+healthcare+facilities+and+are+a+major+cause+for+morbidity+and+mortality+in+hospitalized+patients.+There+is+currently+no+consensus+for+the+most+effective+surveillance+approach+for+MDRO+management.+The+objective+of+this+study+is+to+compare+focused+enhanced+surveillance+for+populations+at+high-risk+for+MDRO+colonization+to+the+current+vertically+oriented+(organism+focused)+surveillance+strategy.+A+cost-effective+analysis+will+be+performed+to+determine+which+approach+is+more+economical.%0D%0A%0D%0AMethods%3A+Electronic+medical+record+surveillance+was+performed+to+randomly+identify+100+high-risk+patients.+Nursing+staff+in+the+UPMC-Mercy+ICUs+and+infection+control+department+gathered+samples+from+patients+for+the+following+MDRO%3A+Methicillin-resistant+Staph+aureus+(MRSA)%2C+Vancomycin+resistant+Enterococci+(VRE)%2C+Carbapenem+resistant+enterobactericiae+(CRE)+and+extended+spectrum+Beta+lactamase+producing+organisms+(ESBL).+Specimens+were+analyzed%2C+and+the+results+were+recorded.+Chart+abstraction+collected+patient+characteristics%2C+severity+index+and+comorbidity+index.+Stata+SE+15.1+was+used+for+data+analysis+to+compare+the+current+surveillance+method+to+the+horizontal+approach.+TreeAge+software+was+used+to+conduct+a+cost-effective+analysis+to+compare+the+two+approaches.+%0D%0A%0D%0AResults%3A+From+Oct+1st%2C+2017+through+Nov.+30th%2C+2017+there+were+total+of+155+eligible+patients+identified+through+EMR+surveillance.+We+screened+74+patients+who+met+our+clinical+criteria+and+26+patients+who+met+our+7-day+length+of+stay+criterion.+There+were+52%25+men+in+our+cohort%2C+with+an+average+age+of+60.1+years.+The+mean+severity+index+was+38.8+and+the+mean+comorbidity+index+was+4.4.++There+was+evidence+of+MDRO+(CRE%2C+ESBL%2C+VRE+%26+MRSA)+in+30%25+of+patients+with+high-risk+clinical+criteria+and+27%25+in+7-day+LOS+patients%2C+as+compared+to+10%25+MRSA+captured+using+the+current+screening+strategy.+Horizontal+surveillance+was+found+to+be+the+cost-effective+approach.%0D%0A%0D%0ADiscussion%3A+Clinical-based+horizontal+surveillance+is+a+more+effective+way+of+identifying+MDRO+colonization+and+infection.+The+next+step+in+our+research+is+to+include+a+larger+patient+sample+to+verify+these+data+results.&rft.date=2018-06-28&rft.type=University+of+Pittsburgh+ETD&rft.type=PeerReviewed&rft.format=application%2Fpdf&rft.language=en&rft.identifier=http%3A%2F%2Fd-scholarship-dev.library.pitt.edu%2F34105%2F1%2FSchmitzEmily_MPHthesis_4_2018.pdf&rft.identifier=++Schmitz%2C+Emily%2FJ++(2018)+Multidrug-resistant+organisms+(MDRO)%3A+cost-effective+analysis+of+horizontal+vs.+vertical+surveillance.++Master's+Thesis%2C+University+of+Pittsburgh.++++(Unpublished)++