Modeling relaxed policies for discontinuation of methicillin-resistant Staphylococcus aureus contact precautions.

Autor:	Cui J; College of Computing, Georgia Institute of Technology, Atlanta, Georgia., Heavey J; Department of Computer Science, University of Virginia, Charlottesville, Virginia., Lin L; Department of Computer Science, University of Virginia, Charlottesville, Virginia., Klein EY; Center for Disease Dynamics, Economics & Policy, Washington, DC.; Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland., Madden GR; Division of Infectious Diseases & International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia., Sifri CD; Division of Infectious Diseases & International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia.; Office of Hospital Epidemiology/Infection Prevention & Control, UVA Health, Charlottesville, Virginia., Lewis B; Biocomplexity Institute, University of Virginia, Charlottesville, Virginia., Vullikanti AK; Department of Computer Science, University of Virginia, Charlottesville, Virginia.; Biocomplexity Institute, University of Virginia, Charlottesville, Virginia., Prakash BA; College of Computing, Georgia Institute of Technology, Atlanta, Georgia.
Jazyk:	angličtina
Zdroj:	Infection control and hospital epidemiology [Infect Control Hosp Epidemiol] 2024 Jul; Vol. 45 (7), pp. 833-838. Date of Electronic Publication: 2024 Feb 26.
DOI:	10.1017/ice.2024.23
Abstrakt:	Objective: To evaluate the economic costs of reducing the University of Virginia Hospital's present "3-negative" policy, which continues methicillin-resistant Staphylococcus aureus (MRSA) contact precautions until patients receive 3 consecutive negative test results, to either 2 or 1 negative. Design: Cost-effective analysis. Settings: The University of Virginia Hospital. Patients: The study included data from 41,216 patients from 2015 to 2019. Methods: We developed a model for MRSA transmission in the University of Virginia Hospital, accounting for both environmental contamination and interactions between patients and providers, which were derived from electronic health record (EHR) data. The model was fit to MRSA incidence over the study period under the current 3-negative clearance policy. A counterfactual simulation was used to estimate outcomes and costs for 2- and 1-negative policies compared with the current 3-negative policy. Results: Our findings suggest that 2-negative and 1-negative policies would have led to 6 (95% CI, -30 to 44; P < .001) and 17 (95% CI, -23 to 59; -10.1% to 25.8%; P < .001) more MRSA cases, respectively, at the hospital over the study period. Overall, the 1-negative policy has statistically significantly lower costs ($628,452; 95% CI, $513,592-$752,148) annually ( P < .001) in US dollars, inflation-adjusted for 2023) than the 2-negative policy ($687,946; 95% CI, $562,522-$812,662) and 3-negative ($702,823; 95% CI, $577,277-$846,605). Conclusions: A single negative MRSA nares PCR test may provide sufficient evidence to discontinue MRSA contact precautions, and it may be the most cost-effective option.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu