Antimicrobial-resistant organism admission screening adherence using a clinical information system and its impact on methicillin-resistant Staphylococcus aureus rates in a provincial healthcare system

Objective Evaluate adherence using the antimicrobial resistant organism (ARO) admission screening tool in the provincial clinical information system (CIS) in Alberta and its relationship with hospital ARO rates. Methods A population-based, serial cross-sectional study examined admissions to acute care facilities using the CIS and where ARO screening for methicillin-resistant Staphylococcus aureus (MRSA) and carbapenemase producing organisms (CPO) was completed by healthcare providers (January 1, 2020-March 31, 2024). Adherence was the proportion of admissions with a completed ARO screening tool in the CIS. MRSA and CPO colonization or infection rates were incident cases per 1,000 admissions or 10,000 patient-days, respectively. Generalized linear models (GLMs) assessed factors associated with adherence. Spearman rank correlations and GLMs assessed the relationship between adherence and ARO rates. Results Ninety-two percent of eligible facilities were included. Overall adherence ranged from 43%-65%. After adjustment for bed size and health zone, adherence declined with increasing months of CIS use (aIRR 0.987, 95%CI 0.986-0.987). Higher adherence was associated with lower overall MRSA infection rates (r s = -0.68) and remained in adjusted models (aIRR 0.99, 95% CI 0.986-0.994). Conclusions Greater adherence to ARO admission screening was associated with lower MRSA infection rates, although the effect size was small. Further work is needed to clarify the relationship between ARO screening and ARO transmission in hospitals.