title: Costs and Benefits Associated with the MRSA Search and Destroy Policy in a Hospital in the Region Kennemerland, The Netherlands.
abstract: OBJECTIVE
  The objective of this study was to analyze the costs and benefits of the MRSA Search and Destroy (S&D) policy between 2008 and 2013 in the Kennemer Gasthuis, a 400 bed teaching hospital in the region Kennemerland, the Netherlands.
  
  
  METHODS
  A patient registration database was used to retrospectively calculate costs, including screening, isolation, follow-up, contact tracing, cleaning, treatment, deployment of extra healthcare workers, salary for an infection control practitioner (ICP) and service of isolation rooms. The estimated benefits (costs and lives when no MRSA S&D was applied) were based on a varying MRSA prevalence rate (up to 50%).
  
  
  RESULTS
  When no MRSA S&D policy was applied, the additional costs and deaths due to MRSA bacteraemia were estimated to be € 1,388,907 and 33 respectively (at a MRSA prevalence rate of 50%). Currently, the total costs were estimated to be € 290,672 (€ 48,445 annually) and a MRSA prevalence rate of 17.3% was considered as break-even point. Between 2008 and 2013, a total of 576 high risk patients were screened for MRSA carriage, of whom 19 (3.3%) were found to be MRSA positive. Forty-nine patients (72.1%) were found unexpectedly.
  
  
  CONCLUSIONS
  Application of the MRSA S&D policy saves lives and money, although the high rate of unexpected MRSA cases is alarming.
authors: Department of Epidemiology and Infection Prevention, Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands.
authors: Dennis
authors: D
authors: Souverein
authors: Department of Infection Control, Kennemer Gasthuis, Haarlem, The Netherlands.
authors: Patricia
authors: P
authors: Houtman
authors: Department of Epidemiology and Infection Prevention, Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands.
authors: Sjoerd M
authors: SM
authors: Euser
authors: Department of Epidemiology and Infection Prevention, Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands.
authors: Bjorn L
authors: BL
authors: Herpers
authors: Laboratory for Microbiology and Infection Control, Amphia Hospital, Breda, and University Medical Center, Utrecht, The Netherlands.
authors: Jan
authors: J
authors: Kluytmans
authors: Department of Epidemiology and Infection Prevention, Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands.
authors: Jeroen W
authors: JW
authors: Den Boer
mesh_terms: D003362:Cost-Benefit Analysis; D004469:Economics, Hospital; D005500:Follow-Up Studies; D006282:Health Personnel; D006801:Humans; D008403:Mass Screening / Q000191:economics; D055624:Methicillin-Resistant Staphylococcus aureus / Q000502:physiology*; D009426:Netherlands / Q000453:epidemiology; D010356:Patient Isolation / Q000191:economics; D012306:Risk; D013203:Staphylococcal Infections / Q000191:economics* / Q000453:epidemiology* / Q000628:therapy