Screening High-Risk Patients for Methicillin-Resistant<i>Staphylococcus Aureus</i>on Admission to the Hospital Is It Cost Effective?

Papia, Giuseppe; Louie, Marie; Tralla, Arnold; Johnson, Claudette; Collins, Veronica; Simor, Andrew E.

doi:10.1086/501655

Cited by 185 publications

(137 citation statements)

References 18 publications

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“…Hospital infection control is costly and despite some evidence suggesting infection-related costs exceed those of screening and control [4,[21][22][23], the costs and benefits associated with screening are largely unknown. This may lead to reservations regarding strategy implementation and so a greater understanding of the potential benefits and pitfalls is clearly needed.…”

Section: Choosing a Screening Strategymentioning

confidence: 99%

Screening strategies in surveillance and control of methicillin-resistant Staphylococcus aureus (MRSA)

2006

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SUMMARYWith reports of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) continuing to increase and therapeutic options decrease, infection control methods are of increasing importance. Here we investigate the relationship between surveillance and infection control. Surveillance plays two roles with respect to control : it allows detection of infected/colonized individuals necessary for their removal from the general population, and it allows quantification of control success. We develop a stochastic model of MRSA transmission dynamics exploring the effects of two screening strategies in an epidemic setting : random and on admission. We consider both hospital and community populations and include control and surveillance in a single framework. Random screening was more efficient at hospital surveillance and allowed nosocomial control, which also prevented epidemic behaviour in the community. Therefore, random screening was the more effective control strategy for both the hospital and community populations in this setting. Surveillance strategies have significant impact on both ascertainment of infection prevalence and its control.

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Section: Choosing a Screening Strategymentioning

confidence: 99%

Screening strategies in surveillance and control of methicillin-resistant Staphylococcus aureus (MRSA)

2006

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“…Long-term catheters that are implemented to administer chemotherapy predispose patients to MRSA bacteremia and catheter infections. Patients who are admitted from health care facilities or nursing homes should be screened for MRSA colonization [28,29].…”

Section: Discussionmentioning

confidence: 99%

Which Multidrug-Resitant Bacteria are Emerging in Patients with Hematological Malignancies?: One-Year Report

Gedık

Şimşek²,

Yıldırmak³

et al. 2014

Indian J Hematol Blood Transfus

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The aim of this retrospective, observational study was to evaluate the outcomes of bacteremia attacks during neutropenic episodes caused by chemotherapy in patients with hematological cancers by assessing mortality, involved pathogens, antimicrobial therapy and treatment responses. Patients who were older than 14 years of age and developed at least one neutropenic episode after chemotherapy to treat hematological cancer between November 2011 and November 2012 were included in the study. We retrospectively collected demographic, treatment, and survival data for 68 patients with 129 neutropenic episodes. The mean age was 59.36 ± 15.22 years (range 17-80 years), and 41 cases were male. The mean Multinational Association of Supportive Care in Cancer score was 19.56 ± 9.04. A total of 37 (28 %) bacteremia attacks were recorded in 20 cases (29 %). Fatality rates were 50 % in the six cases with bacteremia caused by carbapenem-resistant Gram-negative bacteria; death occurred in two patients with carbapenem-resistant Acinetobacter baumannii and in one patient with carbapenem-resistant Pseudomonas aeruginosa. Clinical and microbiological responses were achieved using PIP-TAZ or CEP-SUL treatment in 80 % (16/20) of the cases with bacteremia caused by carbapenem-sensitive Gram-negative bacteria (CS-GNB). During 547 colonization-days in 21 (30 %) vancomycinresistant enterococci (VRE)-colonized cases among 68 patients, vancomycin-resistant Enterococcus faecium bacteremia developed in two patients. Non-carbapenem-based therapy can cure most bacteremia attacks caused by CS-GNB in patients with hematological cancer. However, bacteremia and other infections caused by drug-resistant pathogens, such as A. baumannii, P. aeruginosa, and VRE, are a growing concern in hematological patients.

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“…On the other hand, Calfee et al (2002) 40 estimated that the reduction in MRSA bacteremia as a result of active surveillance and isolation measures is associated with a saving of US$313,596 to $975,632 for one hospital over one year. Papia et al 42 demonstrated that early identification of six or more new MRSA-colonized patients, and the consequent decrease in transmission, makes the active surveillance program cost-effective. Karchmer et al 43 estimated that the cost of active surveillance and isolation of patients colonized and infected by MRSA was 19-27 times lower than that attributable to MRSA bacteremia as a result of an uncontrolled outbreak.…”

Section: Active Surveillance Of Colonization For Patientsmentioning

confidence: 99%

Prevention strategies for methicillin-resistant Staphylococcus aureus (MRSA) in Latin America

Labarca¹,

Salles²

2010

Braz J Infect Dis

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After the first reports of the emergence of methicillin-resistant Staphylococcus aureus (MRSA) in the 1970s, numerous measures intended to prevent its transmission were initiated in hospitals. However, in most cases, large-scale measures failed to be implemented and the transmission of MRSA has since led to a global pandemic. Presently, doubts still remain about the best approach to prevent and control MRSA and more often than not, control measures are not implemented. Therefore, we review here the current situation in Latin America with respect to existing policies for control of MRSA, and evaluate the evidence for control measures in hospitals and the community. We look at the risk factors for infection and transmission of MRSA between hospital patients and within specific populations in the community, and at the effect of antibiotic usage on the spread of MRSA in these settings. Finally, we summarize recommendations for the prevention and control of MRSA, which can be applied to the Latin American hospital environment and community setting.

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Screening High-Risk Patients for Methicillin-ResistantStaphylococcus Aureuson Admission to the Hospital Is It Cost Effective?

Abstract: If early identification of MRSA in colonized patients prevents nosocomial transmission of the organism to as few as six new patients, the screening program would save money.

Cited by 185 publications

References 18 publications

Screening strategies in surveillance and control of methicillin-resistant Staphylococcus aureus (MRSA)

Screening strategies in surveillance and control of methicillin-resistant Staphylococcus aureus (MRSA)

Which Multidrug-Resitant Bacteria are Emerging in Patients with Hematological Malignancies?: One-Year Report

Prevention strategies for methicillin-resistant Staphylococcus aureus (MRSA) in Latin America

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