title: Additional costs for preventing the spread of methicillin-resistant Staphylococcus aureus and a strategy for reducing these costs on a surgical ward.
abstract: OBJECTIVE
  To determine the added costs of hygienic measures (barrier precautions, isolation, and decontamination) required for MRSA carriers in German hospitals and possible strategies for cost reduction.
  
  
  METHODS
  On a septic surgical ward caring for 35% of all MRSA cases in a university hospital (1,182 beds), additional costs for personnel time and materials were calculated and medical charts of all MRSA cases admitted to the ward during 1 year were analyzed retrospectively. Twelve of the ward's 13 beds were located in rooms with at least 2 beds.
  
  
  METHODS
  Four hundred ninety-eight MRSA carrier hospital-days (of 20 MRSA cases) could be assessed. All patients (80% men, 50% older than 74.5 years) had broken skin.
  
  
  RESULTS
  In 95% of the cases, microbiological findings suggested transmission of MRSA during the current or a previous stay on this ward. The study found total avoidable costs of approximately 142,794.01 euros in 1 year, averaging 371.95 euros for one MRSA patient hospital-day and 9,261.56 euros per MRSA case. The most expensive single measure was blocked beds in multibed rooms (305.75 euros/day), which accounted for 82% of the extra costs. Costs most likely were underestimated.
  
  
  CONCLUSIONS
  Daily additional case costs amounted to 96% of social security payments. Blocked beds in multibed rooms accounted for more than 80% of these excess costs. Isolation has been scientifically validated and is required by law in Germany. Building an adequate number of single-bed rooms should help prevent spread and would greatly lower the added costs of infection.
mesh_terms: D000368:Aged; D003363:Cost Control; D003365:Costs and Cost Analysis; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D008297:Male; D008485:Medical Audit; D016106:Methicillin Resistance; D008875:Middle Aged; D010356:Patient Isolation / Q000191:economics; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000191:economics*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000472:pathogenicity; D013503:Surgery Department, Hospital / Q000191:economics*