van Rijen M M L, Kluytmans J A J W
Laboratory for Microbiology and Infection Control, Amphia Hospital Breda, Langendijk 75, P.O. Box 90157, 4800 RL, Breda, The Netherlands.
Eur J Clin Microbiol Infect Dis. 2009 Oct;28(10):1245-52. doi: 10.1007/s10096-009-0775-8. Epub 2009 Jul 18.
The objective of this study was to determine the costs and benefits of the MRSA Search and Destroy policy in a Dutch hospital during 2001 through 2006. Variable costs included costs for isolation, contact tracing, treatment of carriers and closure of wards. Fixed costs were the costs for the building of isolation rooms and the salary of one full-time infection control practitioner. To determine the benefits of the Search and Destroy policy, the transmission rate during the study period was calculated. Furthermore, the number of cases of meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia prevented was estimated, as well as its associated prevented costs and patient lives. The costs of the MRSA policy were estimated to be euro 215,559 a year, which equals euro 5.54 per admission. The daily isolation costs for MRSA-suspected and -positive hospitalised patients were euro 95.59 and euro 436.62, respectively. Application of the Search and Destroy policy resulted in a transmission rate of 0.30 and was estimated to prevent 36 cases of MRSA bacteraemia per year, resulting in annual savings of euro 427,356 for the hospital and ten lives per year (95% confidence interval [CI] 8-14). In conclusion, application of the MRSA Search and Destroy policy in a hospital in a country with a low endemic MRSA incidence saves money and lives.
本研究的目的是确定2001年至2006年期间荷兰一家医院实施耐甲氧西林金黄色葡萄球菌（MRSA）筛查与清除政策的成本和效益。可变成本包括隔离、接触者追踪、携带者治疗和病房关闭的成本。固定成本是隔离病房建设成本和一名全职感染控制从业人员的工资。为了确定筛查与清除政策的效益，计算了研究期间的传播率。此外，还估算了预防的耐甲氧西林金黄色葡萄球菌（MRSA）菌血症病例数及其相关的预防成本和挽救的患者生命数。MRSA政策的成本估计为每年215,559欧元，相当于每次住院5.54欧元。疑似和确诊MRSA的住院患者的每日隔离成本分别为95.59欧元和436.62欧元。实施筛查与清除政策导致传播率为0.30，估计每年可预防36例MRSA菌血症，为医院每年节省427,356欧元，并每年挽救10条生命（95%置信区间[CI] 8 - 14）。总之，在MRSA地方发病率较低的国家，在医院实施MRSA筛查与清除政策可节省资金并挽救生命。
