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Additional Costs for Preventing the Spread of Methicillin-Resistant Staphylococcus aureus and a Strategy for Reducing These Costs on a Surgical Ward

  • Caroline Eva Wella Herr (a1), Thomas Hilarius Heckrodt (a1), Frank Andreas Hofmann (a1), Reinhard Schnettler (a2) and Thomas Friedrich Eikmann (a1)...
Abstract
Objective:

To determine the added costs of hygienic measures (barrier precautions, isolation, and decontamination) required for MRSA carriers in German hospitals and possible strategies for cost reduction.

Design:

On a septic surgical ward caring for 35% of all MRSA cases in a university hospital (1,182 beds), additional costs for personnel time and materials were calculated and medical charts of all MRSA cases admitted to the ward during 1 year were analyzed retrospectively. Twelve of the ward's 13 beds were located in rooms with at least 2 beds.

Patients:

Four hundred ninety-eight MRSA carrier hospital-days (of 20 MRSA cases) could be assessed. All patients (80% men, 50% older than 74.5 years) had broken skin.

Results:

In 95% of the cases, microbiological findings suggested transmission of MRSA during the current or a previous stay on this ward. The study found total avoidable costs of approximately 142,794.01 euros in 1 year, averaging 371.95 euros for one MRSA patient hospital-day and 9,261.56 euros per MRSA case. The most expensive single measure was blocked beds in multibed rooms (305.75 euros/day), which accounted for 82% of the extra costs. Costs most likely were underestimated.

Conclusions:

Daily additional case costs amounted to 96% of social security payments. Blocked beds in multibed rooms accounted for more than 80% of these excess costs. Isolation has been scientifically validated and is required by law in Germany. Building an adequate number of single-bed rooms should help prevent spread and would greatly lower the added costs of infection.

Copyright
Corresponding author
Institute of Hygiene and Environmental Medicine, Justus-Liebig University of Giessen, Friedrichstrasse 16, D-35385 Giessen, Germany
References
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1.Farr, BM, Jarvis, WR. Would active surveillance cultures help control healthcare-related methicillin-resistant Staphylococcus aureus infections? Infect Control Hosp Epidemiol 2002;23:6568.
2.Geldner, G, Ruoff, M, Hoffmann, HJ, Kiefer, P, Georgieff, M, Wiedeck, H. Cost analysis concerning MRSA-infection in ICU [in German]. Anasthesiol Intensivmed Notfallmed Schmerzther 1999;34:409413.
3.Rubin, RJ, Harrington, CAPoon, A, Dietrich, K, Greene, JAMoiduddin, AThe economic impact of Staphylococcus aureus infection in New York City hospitals. Emerg Infect Dis 1999;5:917.
4.Kim, X, Oh, PI, Simor, AE. The economic impact of methicillin-resistant Staphylococcus aureus in Canadian hospitals. Infect Control Hosp Epidemiol 2001;22:99104.
5.Papia, G, Louie, M, Tralla, A, Johnson, C, Collins, V, Simor, AE. Screening high-risk patients for methicillin-resistant Staphylococcus aureus on admission to the hospital: is it cost effective? Infect Control Hosp Epidemiol 1999;20:473477.
6.Chaix, C, Durand-Zaleski, I, Alberti, C, Brun-Buisson, C. Control of endemic methicillin-resistant Staphylococcus aureus: a cost-benefit analysis in an intensive care unit. JAMA 1999;282:17451751.
7.Karchmer, TB, Durbin, LJ, Simonton, BM, Farr, BM. Cost-effectiveness of active surveillance cultures and contact/droplet precautions for control of methicillin-resistant Staphylococcus aureus. J Hosp Infect 2002;51:126132.
8.Empfehlung zur Prävention und Kontrolle von Methicillin-resistent Staphylococcus aureus-Stämmen (MRSA) in Krankenhäusern und anderen medizinischen Einrichtungen: Mitteilung der Kommission für Krankenhaushygiene und Infektionsprävention am RKI. Bundesgesundheitsbl 1999;42:954958.
9.Hospital Infection Control Practices Advisory Committee. Guideline for isolation precautions in hospitals: Part II. Recommendations for isolation precautions in hospitals. Am J Infect Control 1996;24:3252.
10.Gesetz zur Verhütung und Bekämpfung von Infektionskrankheiten beim Menschen Infektionsschutzgesetz: IFSG. Bundesgesetzblatt Jahrgang 2000;33.
11.Domann, E, Hossain, H, Fussle, R, Chakraborty, T. Rapid and reliable detection of multiresistant Staphylococcus aureus (MRSA) by multiplex PCR [in German]. Dtsch Med Wochenschr 2000;125:613618.
12.Vandenbroucke-Grauls, CM. Methicillin-resistant Staphylococcus aureus control in hospitals: the Dutch experience. Infect Control Hosp Epidemiol 1996;17:512513.
13.Minnesota Department of Health, Infectious Disease Prevention and Control Division, Facility and Provider Compliance Division. Guideline for the Management of Antimicrobial Resistant Microorganisms in Minnesota Long-Term Care Facilities. St. Paul, MN: Minnesota Department of Health; 2000. Available at www.health.state.mn.us/divs/dpc/ades/infect/guideline.htm. Accessed August 10, 2003.
14.Rubinovitch, B, Pittet, DI. Screening for methicillin-resistant Staphylococcus aureus in the endemic hospital: what have we learned? J Hosp Infect 2001;47:918.
15.Kluytmans, J, van Belkum, A, Verbrugh, H. Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev 1997;10:505520.
16.Andersen, BM, Lindemann, R, Bergh, K, et al.Spread of methicillin-resistant Staphylococcus aureus in a neonatal intensive unit associated with understaf fing, overcrowding and mixing of patients. J Hosp Infect 2002;50:1824.
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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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