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使用纯次氯酸和莫匹罗星进行普遍去定植以减少重症监护烧伤病房患者耐甲氧西林金黄色葡萄球菌感染的成本分析。

Cost-analysis of universal decolonization with pure hypochlorous acid and mupirocin to reduce MRSA infections in intensive care burn unit patients.

作者信息

Mallow Peter J, Chakravarthy Debashish, Foster Kevin

机构信息

Department of Health Services Administration, Xavier University, Cincinnati, OH, United States.

Urgo Medical North America, Dallas, TX, United States.

出版信息

Front Pharmacol. 2025 Jun 17;16:1606589. doi: 10.3389/fphar.2025.1606589. eCollection 2025.

Abstract

INTRODUCTION

Burn patients are at high risk for infections, particularly Methicillin-resistant aureus (MRSA). Universal decolonization strategies have demonstrated effectiveness in reducing infection rates. This study aimed to evaluate the cost implications of using pure hypochlorous acid (pHA) and mupirocin to prevent MRSA infections in hospitalized burn patients.

METHODS

A patient-level microsimulation model was developed to perform a cost analysis from the US health system perspective. Clinical inputs were derived from a retrospective observational study. The primary outcome was the reduction in MRSA infections per 1,000 bed days. Cost estimates, expressed in 2023 US dollars, were gathered through a pragmatic literature review of publicly available sources. Deterministic and probabilistic sensitivity analyses were conducted to assess the robustness of the findings.

RESULTS

Before the introduction of pHA, burn patients were 3.05 times more likely to develop MRSA infections. The estimated cost of treating MRSA infections was $224,376 per 1,000 bed days in the pre-pHA period, compared to $148,812 in the post-pHA period. After including the cost of pHA, the net savings amounted to $75,564 per 1,000 bed days, or $75.56 per bed day. Sensitivity analyses confirmed the robustness of these results across a range of input values.

CONCLUSION

The combination of pHA and mupirocin appears to be a cost-saving strategy for reducing MRSA infections among hospitalized burn patients.

摘要

引言

烧伤患者感染风险高,尤其是耐甲氧西林金黄色葡萄球菌(MRSA)感染。普遍的去定植策略已证明在降低感染率方面有效。本研究旨在评估使用纯次氯酸(pHA)和莫匹罗星预防住院烧伤患者MRSA感染的成本效益。

方法

建立了一个患者层面的微观模拟模型,从美国卫生系统的角度进行成本分析。临床数据来源于一项回顾性观察研究。主要结局是每1000个床位日MRSA感染的减少情况。成本估算以2023年美元表示,通过对公开可用来源的实用文献综述收集。进行了确定性和概率性敏感性分析,以评估研究结果的稳健性。

结果

在引入pHA之前,烧伤患者发生MRSA感染的可能性高出3.05倍。在引入pHA之前,每1000个床位日治疗MRSA感染的估计成本为224,376美元,而在引入pHA之后为148,812美元。纳入pHA的成本后,每1000个床位日的净节省为75,564美元,即每天每床位节省75.56美元。敏感性分析证实了这些结果在一系列输入值范围内的稳健性。

结论

pHA和莫匹罗星的联合使用似乎是一种节省成本的策略,可减少住院烧伤患者的MRSA感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9619/12208844/09ac9416fbc5/fphar-16-1606589-g001.jpg

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