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The Cost-Effectiveness of an Environmental Intervention on Carbapenem-Resistant Klebsiella pneumonia Healthcare-Associated Infection Control

Meilian Chen, Huan Mai, Yan Gao*

Aim: Conducted environmental intervention on Carbapenem-Resistant Klebsiella Pneumoniae (CRKP) to evaluate the effect and cost. Background: Environmental disinfection is important prevention and control measures for Carbapenem-Resistant Enterobacteriaceae (CRE). Methods: During pre-intervention phase, monitored disinfection effect of environment around patients randomly through microbiological tests quarterly and feedback to supervise environment disinfection. During intervention phase, targeted microbiological monitoring disinfection effect of environment around CRKP patients, used multiple monitoring methods including fluorescent labelling, Adenosine Triphosphate (ATP) to strengthen monitoring. Compared CRKP Healthcare-Associated Infections (HAI) rates and surroundings monitoring qualification rates, calculated the increased cost and effect. Results: 44 CRKP positive patients were included from January 2018 to June 2019. CRKP HAI rate decreased from 6.49/1000 admissions in pre-intervention phase to 3.08/1000 in intervention phase, microbiological monitoring qualification rate increased from 79.09% to 90.50%. Total environmental intervention cost was CNY6211.00. CRKP HAI and death cases decreased 3.33, 2.50 respectively. Increased CNY1865.17 environmental intervention cost could prevent one CRKP HAI case, increased CNY2484.40 cost could reduce one CRKP death case. Conclusion: CRE infection is persistent threat. Environmental intervention could be cost-effectively measure.