Is it worth screening for vancomycin-resistant Enterococcus faecium colonization?: Financial burden of screening in a developing country

Autor: Aysegul Ulu-Kilic, Emine Alp, Duygu Perçin, Tamer Gunes, Esra Özhan, Dilek Altun
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Male
0301 basic medicine
Adolescent
Turkey
Epidemiology
Critical Illness
Enterococcus faecium
030106 microbiology
Drug resistance
Vancomycin-Resistant Enterococci
law.invention
03 medical and health sciences
0302 clinical medicine
law
Humans
Mass Screening
Medicine
Colonization
030212 general & internal medicine
Child
Developing Countries
Gram-Positive Bacterial Infections
Retrospective Studies
Finance
Infection Control
biology
business.industry
Transmission (medicine)
Health Policy
Incidence (epidemiology)
Infant
Newborn
Public Health
Environmental and Occupational Health
Infant
biochemical phenomena
metabolism
and nutrition
biology.organism_classification
bacterial infections and mycoses
Intensive care unit
digestive system diseases
Infectious Diseases
Child
Preschool
Carrier State
Costs and Cost Analysis
Vancomycin
Female
business
Asymptomatic carrier
medicine.drug
Popis: Background The screening of critically ill patients at high risk of vancomycin resistant enterococci (VRE) colonization, to detect and isolate colonized patients, is recommended to prevent and control the transmission of VRE. Screening asymptomatic carriers brings financial burden for institutions. In this study, we performed risk analysis for VRE colonization and determined the financial burden of screening in a middle-income country, Turkey. Methods We retrospectively analyzed the VRE surveillance data from a pediatric hospital between 2010 and 2014. A case-control study was conducted to identify the risk factors of colonization. Total cost of VRE screening and additional costs for a VRE colonized patient (including active surveillance cultures and contact isolation) were calculated. Results During the 4-year period, 6,372 patients were screened for perirectal VRE colonization. The rate of culture-positive specimens among all patients screened was 239 (3.75%). The rate of VRE infection was 0.04% (n = 3) among all patients screened. Length of hospital stay, malignancy, and being transferred from another institution were independently associated risk factors for colonization. Annual estimated costs for the laboratory were projected as $19,074 (76,295/4) for all patients screened. Cost of contact isolation for each patient colonized in a ward and an intensive care unit was $270 and $718, respectively. Conclusions In developing countries, institutions should identify their own high-risk patients; screening priorities should be based on prevalence of infection and hospital financial resources.
Databáze: OpenAIRE
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