title: Cost Analysis of an Intervention to Prevent Methicillin-Resistant Staphylococcus Aureus (MRSA) Transmission.
abstract: BACKGROUND
  Our objective was to assess the cost implications of a vertical MRSA prevention program that led to a reduction in MRSA bacteremia.
  
  
  METHODS
  We performed a matched historical cohort study and cost analysis in a single hospital in Israel for the years 2005-2011. The cost of MRSA bacteremia was calculated as total hospital cost for patients admitted with bacteremia and for patients with hospital-acquired bacteremia, the difference in cost compared to matched controls. The cost of prevention was calculated as the sum of the cost of microbiology tests, single-use equipment used for patients in isolation, and infection control personnel.
  
  
  RESULTS
  An average of 20,000 patients were screened yearly. The cost of prevention was $208,100 per year, with the major contributor being laboratory cost. We calculated that our intervention averted 34 cases of bacteremia yearly: 17 presenting on admission and 17 acquired in the hospital. The average cost of a case admitted with bacteremia was $14,500, and the net cost attributable to nosocomial bacteremia was $9,400. Antibiotics contributed only 0.4% of the total disease management cost. When the annual cost of averted cases of bacteremia and that of prevention were compared, the intervention resulted in annual cost savings of $199,600.
  
  
  CONCLUSIONS
  A vertical MRSA prevention program targeted at high-risk patients, which was highly effective in preventing bacteremia, is cost saving. These results suggest that allocating resources to targeted prevention efforts might be beneficial even in a single institution in a high incidence country.
authors.affiliation: Infectious Diseases Unit, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors.forename: Michal
authors.initials: M
authors.lastname: Chowers
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel; National Center for Infection and Antibiotic Resistance Control, Tel Aviv Medical Center, Tel Aviv, Israel.
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Carmeli
authors.affiliation: Infectious Diseases Unit, Meir Medical Center, Kfar Saba, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors.forename: Pnina
authors.initials: P
authors.lastname: Shitrit
authors.affiliation: Department of Management, Bar Ilan University, Ramat Gan, Israel.
authors.forename: Asher
authors.initials: A
authors.lastname: Elhayany
authors.affiliation: Department of economics, Meir Medical Center, Kfar Saba, Israel.
authors.forename: Keren
authors.initials: K
authors.lastname: Geffen
mesh_terms: D000900:Anti-Bacterial Agents / Q000191:economics / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis / Q000191:economics* / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000191:economics* / Q000382:microbiology / Q000517:prevention & control; D017721:Hospital Costs; D006801:Humans; D017053:Infection Control / Q000191:economics*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D013203:Staphylococcal Infections / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission
chemical_list: D000900:Anti-Bacterial Agents