Watson Paul Andrew, Watson Luke Robert, Torress-Cook Alfonso
Lakeside Orthopedics, Omaha, NE, USA.
College Medical Center, Long Beach, CA, USA.
J Infect Prev. 2016 Jul;17(4):171-176. doi: 10.1177/1757177416645342. Epub 2016 May 13.
Environmental contamination has been associated with over half of methicillin-resistant (MRSA) outbreaks in hospitals. We explored if a hospital-wide environmental and patient cleaning protocol would lower hospital acquired MRSA rates and associated costs.
This study evaluates the impact of implementing a hospital-wide environmental and patient cleaning protocol on the rate of MRSA infection and the potential cost benefit of the intervention.
A retrospective, pre-post interventional study design was used. The intervention comprised a combination of enhanced environmental cleaning of high touch surfaces, daily washing of patients with benzalkonium chloride, and targeted isolation of patients with active infection. The rate of MRSA infection per 1000 patient days (PD) was compared with the rate after the intervention (Steiros Algorithm) was implemented. A cost-benefit analysis based on the number of MRSA infections avoided was conducted.
The MRSA rates decreased by 96% from 3.04 per 1000 PD to 0.11 per 1000 PD ( <0.0001). This reduction in MRSA infections, avoided an estimated $1,655,143 in healthcare costs.
Implementation of this hospital-wide protocol appears to be associated with a reduction in the rate of MRSA infection and therefore a reduction in associated healthcare costs.
环境污染与医院中超过半数的耐甲氧西林金黄色葡萄球菌（MRSA）暴发有关。我们探究了一项全院范围的环境及患者清洁方案是否会降低医院获得性MRSA感染率及相关成本。
本研究评估实施一项全院范围的环境及患者清洁方案对MRSA感染率的影响以及该干预措施潜在的成本效益。
采用回顾性、干预前后对照的研究设计。干预措施包括加强对高接触表面的环境清洁、每日用苯扎氯铵为患者洗浴以及对活动性感染患者进行针对性隔离。将每1000患者日（PD）的MRSA感染率与实施干预措施（Steiros算法）后的感染率进行比较。基于避免的MRSA感染数量进行成本效益分析。
MRSA感染率从每1000 PD 3.04降至每1000 PD 0.11，降幅达96%（<0.0001）。MRSA感染率的降低避免了估计达1,655,143美元的医疗成本。
实施这项全院范围的方案似乎与MRSA感染率降低相关，因此也降低了相关的医疗成本。
