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 |
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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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