title: Costs and benefits of the MRSA Search and Destroy policy in a Dutch hospital.
abstract: The objective of this study was to determine the costs and benefits of the MRSA Search and Destroy policy in a Dutch hospital during 2001 through 2006. Variable costs included costs for isolation, contact tracing, treatment of carriers and closure of wards. Fixed costs were the costs for the building of isolation rooms and the salary of one full-time infection control practitioner. To determine the benefits of the Search and Destroy policy, the transmission rate during the study period was calculated. Furthermore, the number of cases of meticillin-resistant Staphylococcus aureus (MRSA) bacteraemia prevented was estimated, as well as its associated prevented costs and patient lives. The costs of the MRSA policy were estimated to be euro 215,559 a year, which equals euro 5.54 per admission. The daily isolation costs for MRSA-suspected and -positive hospitalised patients were euro 95.59 and euro 436.62, respectively. Application of the Search and Destroy policy resulted in a transmission rate of 0.30 and was estimated to prevent 36 cases of MRSA bacteraemia per year, resulting in annual savings of euro 427,356 for the hospital and ten lives per year (95% confidence interval [CI] 8-14). In conclusion, application of the MRSA Search and Destroy policy in a hospital in a country with a low endemic MRSA incidence saves money and lives.
authors.affiliation: Laboratory for Microbiology and Infection Control, Amphia Hospital Breda, Langendijk 75, P.O. Box 90157, 4800 RL, Breda, The Netherlands. mvrijen@amphia.nl
authors.forename: M M L
authors.initials: MM
authors.lastname: van Rijen
authors.forename: J A J W
authors.initials: JA
authors.lastname: Kluytmans
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D016470:Bacteremia / Q000191:economics / Q000517:prevention & control; D002353:Carrier State / Q000191:economics; D016358:Contact Tracing / Q000191:economics; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000191:economics* / Q000517:prevention & control*; D004196:Disease Outbreaks / Q000517:prevention & control; D006271:Health Facility Closure / Q000191:economics; D006291:Health Policy / Q000191:economics; D017721:Hospital Costs; D006801:Humans; D017053:Infection Control / Q000191:economics* / Q000379:methods; D016357:Infection Control Practitioners / Q000191:economics; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D009426:Netherlands; D013203:Staphylococcal Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission
chemical_list: D000900:Anti-Bacterial Agents