Lab Cost Analysis of CPE Screening Methods

Methods to screen carbapenemase-producing Enterobacteriaceae can range from an annual cost of approximately $23,000 to $225,000 when factoring in the program cost and lab technician hours, according to a study in Infection Control and Hospital Epidemiology.

Researchers compared the cost and accuracy of CPE perirectal screening methods from the Centers for Disease Control and Prevention, a similar screening method with chromogenic agar — a growth medium that identifies desired bacterial genetic traits through color — and a molecular testing method.

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They found the CDC protocol would be $22,818 annually for a single lab, including 482 hours of technician work. The CA-modified protocol would cost $37,411 annually with 376 hours of technician work, and molecular testing would cost $224,596 with 343 hours of technician work.

The CDC and CA methods had a three-day turnaround time, while molecular test results could be produced in just one day.

Additionally, the CDC method had the lowest sensitivity. Researchers estimated the CDC method would miss 92 CPE-positive isolates over the assessment period, while the CA-modified method would have missed an estimated 26 positive results.

Researchers suggest that while the CDC method is cheaper, its high required number of technician hours and lower sensitivity may justify using other methods of CRE detection.

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