Rapid diagnostic testing of methicillin-resistant Staphylococcus aureus carriage at different anatomical sites: costs and benefits of less extensive screening regimens

Autor: Petra F. G. Wolffs, Marjan W. M. Wassenberg, G.A. de Wit, M.W.H. Wulf, R.W. Bosboom, Marc J. M. Bonten, Annet Troelstra, Steven F. T. Thijsen, Andreas Voss, Willem J. G. Melchers, A.G.M. Buiting, A. A. Van Zwet, Christina M. J. E. Vandenbroucke-Grauls, Jan Kluytmans, Caroline E. Visser, E.P.M. van Elzakker
Přispěvatelé: Medical Microbiology and Infection Prevention, CCA - Immuno-pathogenesis, CCA - Quality of life, Medische Microbiologie, RS: CAPHRI School for Public Health and Primary Care, AII - Amsterdam institute for Infection and Immunity
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Microbiology (medical)
Methicillin-Resistant Staphylococcus aureus
medicine.medical_specialty
food.ingredient
Isolation (health care)
Cost effectiveness
Cost-Benefit Analysis
medicine.disease_cause
Microbiology
food
Back-up cultures
stomatognathic system
Predictive Value of Tests
Internal medicine
multiple site screening
medicine
Prevalence
Agar
Humans
Mass Screening
Prospective Studies
cost-effectiveness
MRSA screening
health care economics and organizations
Bacteriological Techniques
GeneXpert MTB/RIF
business.industry
extranasal screening
Pathogenesis and modulation of inflammation Infection and autoimmunity [N4i 1]
General Medicine
Staphylococcal Infections
medicine.disease
Methicillin-resistant Staphylococcus aureus
Carriage
Infectious Diseases
rapid diagnostic testing
Staphylococcus aureus
Bacteremia
Carrier State
business
Zdroj: Clinical Microbiology and Infection, 17(11), 1704-1710
Wassenberg, M W M, Kluijtmans, J A J W, Bosboom, R W, Buiting, A G M, van Elzakker, E P M, Melchers, W J G, Thijsen, S F T, Troelstra, A, Vandenbroucke-Grauls, C M J E, Visser, C E, Voss, A, Wolffs, P F G, Wulf, M W H, van Zwet, A A, de Wit, G A & Bonten, M J M 2011, ' Rapid diagnostic testing of methicillin-resistant Staphylococcus aureus carriage at different anatomical sites: costs and benefits of less extensive screening regimens ', Clinical Microbiology and Infection, vol. 17, no. 11, pp. 1704-1710 . https://doi.org/10.1111/j.1469-0691.2011.03502.x
Clinical Microbiology and Infection, 17(11), 1704-1710. ELSEVIER SCI LTD
Clinical microbiology and infection, 17(11), 1704-1710. Elsevier Limited
Clinical Microbiology and Infection, 17, 11, pp. 1704-10
Clinical Microbiology and Infection, 17, 1704-10
ISSN: 1198-743X
Popis: Item does not contain fulltext Multiple body site screening and pre-emptive isolation of patients at risk for methicillin-resistant Staphylococcus aureus (MRSA) carriage are considered essential for control of nosocomial spread. The relative importance of extranasal screening when using rapid diagnostic testing (RDT) is unknown. Using data from a multicentre study evaluating BD GeneOhm MRSA PCR (IDI), Xpert MRSA (GeneXpert) and chromogenic agar, added to conventional cultures, we determined cost-effectiveness assuming isolation measures would have been based on RDT results of different hypothetical screening regimes. Costs per isolation day avoided were calculated for regimes with single or less extensive multiple site RDT, regimes without conventional back-up cultures and when PCR would have been performed with pooling of swabs. Among 1764 patients at risk, MRSA prevalence was 3.3% (n = 59). In all scenarios the negative predictive value is above 98.4%. With back-up cultures of all sites as a reference, the costs per isolation day avoided were euro15.19, euro30.83 and euro45.37 with 'nares only' screening using chromogenic agar, IDI and GeneXpert, respectively, as compared with euro19.95, euro95.77 and euro125.43 per isolation day avoided when all body sites had been screened. Without back-up cultures costs per isolation day avoided using chromogenic agar would range from euro9.24 to euro76.18 when costs per false-negative RDT range from euro5000 up to euro50 000; costs for molecular screening methods would be higher in all scenarios evaluated. In conclusion, in a low endemic setting chromogenic agar screening added to multiple site conventional cultures is the most cost-effective MRSA screening strategy.
Databáze: OpenAIRE
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