Comparative Cost of Selective Screening To Prevent Transmission of Methicillin-Resistant <i>Staphylococcus aureus</i> (MRSA), Compared With the Attributable Costs of MRSA Infection

Gavaldà, Laura; Masuet, Cristina; Beltran, Juan; García, María del Mar Ballesteros; Garcia, D.; Sirvent, Josep Maria; Ramón., José

doi:10.1086/507968

Cited by 44 publications

(23 citation statements)

References 9 publications

(5 reference statements)

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“…Several studies have highlighted the relevance of this epidemiological aspect which might influence the infection control practices implemented by acutecare hospitals [18][19][20][21][22] but there are limited data on the relationship of MRSA colonization and the development of infection in residents of LTCFs [12,14]. This aspect has usually been assessed in settings where patients are at great risk of MRSA infection, such as intensive care units [10].…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of methicillin-resistantStaphylococcus aureuscolonization in residents in community long-term-care facilities in Spain

Manzur¹,

Gopegui

Domı́nguez

et al. 2011

Epidemiol. Infect.

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SUMMARYMethicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in Spanish hospitals and community long-term-care facilities (LTCFs). This longitudinal study was performed in community LTCFs to determine whether MRSA colonization is associated with MRSA infections and overall mortality. Nasal and decubitus ulcer cultures were performed every 6 months for an 18-month period on 178 MRSA-colonized residents (86 490 patient-days) and 196 non-MRSA carriers (97 470 patient-days). Fourteen residents developed MRSA infections and 10 of these were skin and soft tissue infections. Two patients with respiratory infections required hospitalization. The incidence rate of MRSA infection was 0 . 12/1000 patient-days in MRSA carriers and 0 . 05/1000 patient-days in non-carriers (P=0 . 46). No difference in MRSA infection rate was found according to the duration of MRSA colonization (P=0 . 69). The mortality rate was 20 . 8% in colonized residents and 16 . 8 % in non-carriers ; four residents with MRSA infection died. Overall mortality was statistically similar in both cohorts. Our results suggest that despite a high prevalence of MRSA colonization in LTCFs, MRSA infections are neither frequent nor severe while colonized residents remain at the facility. The epidemiological impact of an MRSA reservoir is more relevant than the clinical impact of this colonization for an individual resident and supports current recommendations to control MRSA spread in community LTCFs.

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Section: Discussionmentioning

confidence: 99%

Clinical significance of methicillin-resistantStaphylococcus aureuscolonization in residents in community long-term-care facilities in Spain

Manzur¹,

Gopegui

Domı́nguez

et al. 2011

Epidemiol. Infect.

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“…Previous investigators have described the economic impact of MRSA blood stream infections, screening programs and contact isolation in adult medicine;4-6 however, the impact of MRSA colonization on total hospital cost in the NICU is unknown. We compared MRSA colonized and non-colonized MRSA neonates to determine differences in length of stay, total hospital cost, and the number of new patient admissions prevented by isolation of MRSA colonized neonates.…”

Section: Introductionmentioning

confidence: 99%

Effect of Methicillin-Resistant Staphylococcus aureus Colonization in the Neonatal Intensive Care Unit on Total Hospital Cost

Schultz

Tanaka²,

Goldberg³

et al. 2009

Infect. Control Hosp. Epidemiol.

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“…Studies15 16 have demonstrated that pre-admission screening for MRSA is an effective method to reduce the hospital burden of MRSA-colonised patients, and that the savings outweigh the costs of screening several times. Early reporting of results will strengthen the infection control measures, help in effective ring fencing17 of the colonised patients, and reduce the overall burden of MRSA in the hospital.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Chromogenic MRSA medium, MRSASelect and Oxacillin Resistance Screening Agar for the detection of methicillin-resistant Staphylococcus aureus

Krishna

Smith

McIndeor

et al. 2008

Journal of Clinical Pathology

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Aims: An evaluation of Chromogenic MRSA medium (CMRSA), MRSASelect (MRSAS) and Oxacillin Resistance Screening Agar (ORSA) was performed to determine the optimum medium providing a rapid and sensitive method for methicillin-resistant Staphylococcus aureus (MRSA) detection. Methods: A total of 632 clinical specimens were cultured on the three media in first phase of the study, while 720 clinical specimens were cultured on CMRSA and ORSA in the second phase. Results: The sensitivity and specificity, respectively, of the media in the first phase were: CMRSA 88.9% and 98.45%; MRSAS 92.1% and 99.1%; ORSA (24 h incubation) 68.3% and 98.8%; and ORSA (48 h incubation) 85.7% and 96.3%. In the second phase the sensitivity and specificity, respectively, were CMRSA 91.2% and 98.6%; ORSA (24 h incubation) 58.9% and 98.2%; and ORSA (48 h incubation) 85.6% and 95.6%. The positive predictive values of the two chromogenic media were higher than that for ORSA. There were fewer false-positive results with the chromogenic media (1.4% for CMRSA and 0.8% for MRSAS) compared with ORSA (3.3%). Conclusions: Performing latex agglutination tests on growth from chromogenic media provides results for 93.8% of MRSA isolates within 24 h. There is a small increase in cost of chromogenic media compared with ORSA (£28 for MRSAS, and £36 for CMRSA, per 1000 specimens) and direct agglutination tests (£80 per 1000 specimens). However early availability of MRSA screening results can reduce the burden of MRSA in hospitals because of early implementation of infection control measures.

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Comparative Cost of Selective Screening To Prevent Transmission of Methicillin-Resistant Staphylococcus aureus (MRSA), Compared With the Attributable Costs of MRSA Infection

Cited by 44 publications

References 9 publications

Clinical significance of methicillin-resistantStaphylococcus aureuscolonization in residents in community long-term-care facilities in Spain

Clinical significance of methicillin-resistantStaphylococcus aureuscolonization in residents in community long-term-care facilities in Spain

Effect of Methicillin-Resistant Staphylococcus aureus Colonization in the Neonatal Intensive Care Unit on Total Hospital Cost

Evaluation of Chromogenic MRSA medium, MRSASelect and Oxacillin Resistance Screening Agar for the detection of methicillin-resistant Staphylococcus aureus

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