729. I Can CPO Clearing Now, the Iso is Gone
Bibliographic record
Abstract
Abstract Background There is little research or guidance about clearing patients who are colonized with carbapenemase-producing organisms (CPO). The use of isolation precautions to reduce transmission needs to be balanced with the potential negative impacts of isolation on patient experience, quality of care and non-infection patient safety and outcome measures. Our objective was to develop and implement a standardized provincial protocol for clearing patients of their CPO-positive status. Methods PubMed, Web of Science, EMBASE and Cochrane Library were searched from January 2000 to February 2023. Randomized control trials, retrospective and prospective cohort studies, cross-sectional studies and case series were included. This information was used to create a CPO clearing protocol for use by Alberta Health Services (AHS) Infection Prevention and Control (IPC). The protocol will be monitored through the provincial surveillance system (ProvSurv) to guide future changes. Results The literature showed that although CPO colonization can be prolonged (more than 12 months), a significant number of patients tested CPO-negative by 3 months since the last positive test. In addition, one-third of patients with 1 or 2 negative swabs subsequently tested CPO-positive. Therefore, the proposed provincial guidance is to re-screen patients 3 months after their last CPO-positive result. Three negative sets (without antibiotic pressure) done at least one week apart are required to clear a CPO flag; where a negative set includes a rectal swab or stool culture, cultures of previously positive sites if still clinically relevant, and additional currently relevant sites. Conclusion This project aimed to create a standardized provincial protocol for clearing patients of their CPO-positive status to decrease the duration of isolation, while also balancing resource management and patient-centred care. After implementation, next steps include evaluation by monitoring compliance and examining specific CPO-related indicators. There is potential for use by other healthcare institutions and organizations. Disclosures All Authors: No reported disclosures
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".