MRSA screening in ICU saves hospitals money
16 Feb 2011
Screening patients in the intensive care unit (ICU) for
methicillin-resistant Staphylococcus aureus (MRSA) produces
cost savings for the whole hospital, according to a statistical
simulation model developed by the Minneapolis Veterans Affairs Medical
Center [1].
The aim of the study was to determine the costs per hospital admission of
screening ICU patients for MRSA and isolating patients who tested
positive.
They found that even under the most conservative assumptions the
screening would be cost-neutral if early detection of MRSA would
lead to a reduced rate of infection and transmission within the
hospital. Under optimal assumptions, screening could result in
savings of almost US$500 per hospital admission.
The research assessed the possible impact and cost effectiveness
of active detection of MRSA and isolation on frequency of MRSA
infections in the ICUs and hospital-wide.
“This study presents evidence of the cost savings from
implementing a program that targets the ICU population but that has
an effect that is hospital-wide,” according to Dr Nyman and his
colleagues.
“Although we find that this program pays for itself through the
MRSA infections prevented, it is important that hospitals also
consider how this type of program fits into their overall
institutional, infection-prevention programs and realize that this
intervention is only one of many alternative interventions that are
designed to prevent healthcare-associated infections.”
The authors contend that this approach could complement other
strategies to further reduce the incidence of MRSA infection. “We
owe it to the patients to continue to assess and improve our
preventive strategies,” they say in conclusion.
MRSA is an antibiotic-resistant bacteria that can lead to severe
infections and is associated with approximately 19,000 deaths
annually in the US, according to the Centers for Disease Control and
Prevention (CDC). A 2006 survey conducted by APIC showed that 46 out
of every 1,000 inpatients were either infected or colonized with
MRSA — a rate eight times higher than previous estimates. The annual
cost to treat MRSA in hospitalized patients in the US is estimated at US$3.2
to 4.2 billion.
Some policy-makers have recommended universal screening to reduce
hospital-acquired MRSA infection. APIC has called for a more
targeted, evidence-based approach that allows hospitals to tailor
screening efforts based on their unique situation and recently
published an updated Guide to the Elimination of MRSA Transmission
in Hospital Settings, 2nd Edition, including a section on active
surveillance testing.
“The findings from this research by Dr Nyman and colleagues are
interesting but also highlight the importance of application of
these by infection preventionists, based on risk assessment at their
affiliated facilities,” said APIC 2011 President Russell Olmsted,
MPH, CIC, Epidemiologist in Infection Prevention & Control Services,
St. Joseph Mercy Health System, Ann Arbor, Michigan.
“A broad focus that addresses prevention of all pathogens is
critical. With the US government’s increased focus on preventing all
HAIs, it will be even more important for facilities to make sure
they are doing everything possible to reduce and ultimately
eliminate these infections.”
Reference
Cost of screening intensive care unit patients for methicillin-resistant
Staphylococcus aureus in hospitals. American Journal of
Infection Control, Volume 39, Issue 1 (February 2011).