Carbapenemase screening - Fast and expensive or cheap and slow?
This exercise in mathematical modelling compares direct PCR screening (half a day) with culture + PCR which required 2.5 days. Taking into account 'days at risk' (when a patient with CP-CRE was not detected and hence not isolated) , total cost and average cost per CP-CRE risk day averted the slower option provided optimal balance of cost and risk days averted.
Of course now RESIST offers culture + identification in 24 hours at considerable less cost than culture + PCR the balance has swung further in favour of culture + identification.
An outbreak of a NDM Klebsiella affecting 40 patients in a group of five hospitals across three sites in West London cost 1.1m euro over 10 months . Less than 10% was allocated to extra laboratory expenditure.
This is the kind of cost that effective patient screening is guarding against.