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rapid molecular surveillance improves IPC and hospital capacity

Lecture : 3 min

5 août 2026

BON USAGE DES ANTIMICROBIENS

Article

New study shows rapid molecular surveillance improves IPC and hospital capacity

Carbapenem-resistant organisms (CROs) pose a global challenge to healthcare systems. These bacteria cause costly, hard-to-treat hospital infections. Early patient identification is crucial, but traditional tests can delay action.

A 7-year study (2017-2023) at IRCCS Humanitas Research Hospital in Italy evaluated the clinical and operational impact of combining rapid molecular screening (PCR) with culture-based methods.1 The findings at this tertiary hospital showed that rapid molecular surveillance improved infection control by enabling faster reporting, and cost savings. 

Cost Saving Quote

Key takeaways from the study include:1

 

  • Faster turnaround enables earlier IPC decisions

PCR testing delivered results in about 2.6 hours, compared to about 50 hours for culture, reducing time to results by more than 40 hours. This faster process allows clinicians to act earlier, particularly by discontinuing pre-emptive isolation sooner when CRO colonization is ruled out.

 

  • High diagnostic performance supports clinical decision-making

 PCR demonstrated strong agreement with culture, alongside 97,7% sensitivity and 99,7% specificity. This means that a negative PCR result supports the rapid exclusion of CRO colonization within hours, compared to days with culture alone, supporting faster, more confident clinical decisions.

 

  • CRO colonization strongly predicts infection risk. 

The study confirmed that CRO colonization is a major risk factor for subsequent bloodstream infection (BSI).

BSI incidence:

2,35 per 1000 patient-days in colonized patients

0,17 per 1000 patient-days in non-colonized patient

Acquired colonization increased BSI risk more than eightfold. This highlights the clinical importance of early detection: not only to prevent transmission, but also to identify patients at elevated risk of severe infection and highlighting the potential clinical relevance of early detection.  

 

  • Rapid PCR Testing Enables Earlier Isolation Decisions and Improves Patient Flow

Because many hospitals use pre-emptive isolation while awaiting CRO screening results, faster diagnostics can significantly reduce unnecessary isolation.

 

  • Compared to culture-based workflows, rapid PCR enables:

o   Discontinuation of isolation within hours rather than days when results are negative

o   Reduced duration of precautionary isolation

o   Earlier patient movement through clinical pathways

By shortening isolation time linked to negative screening results, molecular testing may help reduce the burden on limited isolation rooms and improves overall patient flow.

 

  • Potential Capacity Benefits Through Earlier Decision-Making

The study showed that faster turnaround times translate into operational gains:

o   ~42–45 hours saved per negative result compared to culture

o   Reduction in total bed-days associated with precautionary isolation

o    ~€4 million in potential resource value, estimated in the analysis, unlocked over the study period

o   Capacity to treat ~3 134 (model-based estimate) additional patients

These findings demonstrate that evaluating diagnostics based on cost per test alone may underestimate their broader impact. When assessed across the full care pathway, faster diagnostics can improve both efficiency and access to care.

 

  • Sustaining Low Transmission in High-Risk Settings

In high-risk wards with systematic screening (e.g., ICU and onco-hematology units), rapid molecular surveillance was associated with low CRO acquisition rates reported in the study:

o   1.3 per 1000 patient-days (ICU)

o   0,32 per 1000 patient-days (onco-hematology)

Over time, this approach may support more targeted infection control interventions strategies by aligning rapid diagnostics with isolation decisions and clinical workflows. This has the potential for earlier identification of at-risk patients and more precise containment of transmission.

 

Perspectives

As antimicrobial resistance continues to escalate, healthcare systems are under increasing pressure to improve both clinical outcomes and operational efficiency.

This study demonstrates that rapid PCR screening can play a central role in addressing both challenges. Compared to traditional culture-based approaches, PCR delivers fast, reliable results that help support:

  • Earlier IPC and treatment decisions
  • Identifiying patients at elevated risk of infection
  • Reducing unnecessary isolation
  • Optimize the use of limited hospital resources

 

For healthcare organizations, these findings reinforce the importance of considering not only diagnostic accuracy, but also the downstream clinical and operational impact of faster testing.

Disclosure: This study was supported by a Research Grant from Cepheid.

 

Clause de non-responsabilité : Le contenu présenté sur cette page est destiné à des fins informatives et éducatives. Bien qu’elle soit disponible à l’échelle mondiale, elle peut refléter les pratiques cliniques ou les considérations du système de santé spécifiques à une région particulière.

 

Référence

 

1.    Bollini R., Bavaro D.F., Fazio F., et al. (2026). Clinical and cost benefit of rapid molecular screening for carbapenem-resistant organisms: a seven-year analysis in a tertiary hospital. Antimicrobial Resistance & Infection Control. https://doi.org/10.1186/s13756-026-01750-7  

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