Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2025-01-01T00:07:49.175Z Has data issue: false hasContentIssue false
  • English
  • Français

Additional Costs for Preventing the Spread of Methicillin-Resistant Staphylococcus aureus and a Strategy for Reducing These Costs on a Surgical Ward

Published online by Cambridge University Press:  02 January 2015

Caroline Eva Wella Herr ,
Thomas Hilarius Heckrodt ,
Frank Andreas Hofmann ,
Reinhard Schnettler  and
Thomas Friedrich Eikmann
Caroline Eva Wella Herr*
Affiliation:
Institute of Hygiene and Environmental Medicine, Justus-Liebig University of Giessen, Giessen, Germany
Thomas Hilarius Heckrodt
Affiliation:
Institute of Hygiene and Environmental Medicine, Justus-Liebig University of Giessen, Giessen, Germany
Frank Andreas Hofmann
Affiliation:
Institute of Hygiene and Environmental Medicine, Justus-Liebig University of Giessen, Giessen, Germany
Reinhard Schnettler
Affiliation:
Clinic for Casualty (Emergency) Surgery, Justus-Liebig University of Giessen, Giessen, Germany
Thomas Friedrich Eikmann
Affiliation:
Institute of Hygiene and Environmental Medicine, Justus-Liebig University of Giessen, Giessen, Germany
*
Institute of Hygiene and Environmental Medicine, Justus-Liebig University of Giessen, Friedrichstrasse 16, D-35385 Giessen, Germany
Get access Rights & Permissions [Opens in a new window]

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.

Design:

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.

Patients:

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.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 24 , Issue 9 , September 2003 , pp. 673 - 678
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Farr, BM, Jarvis, WR. Would active surveillance cultures help control healthcare-related methicillin-resistant Staphylococcus aureus infections? Infect Control Hosp Epidemiol 2002;23:65–68.Google Scholar
2.Geldner, G, Ruoff, M, Hoffmann, HJ, Kiefer, P, Georgieff, M, Wiedeck, H. Cost analysis concerning MRSA-infection in ICU [in German]. Anasthesiol Intensivmed Notfallmed Schmerzther 1999;34:409–413.Google Scholar
3.Rubin, RJ, Harrington, CAPoon, A, Dietrich, K, Greene, JAMoiduddin, AThe economic impact of Staphylococcus aureus infection in New York City hospitals. Emerg Infect Dis 1999;5:9–17.CrossRefGoogle ScholarPubMed
4.Kim, X, Oh, PI, Simor, AE. The economic impact of methicillin-resistant Staphylococcus aureus in Canadian hospitals. Infect Control Hosp Epidemiol 2001;22:99–104.Google Scholar
5.Papia, G, Louie, M, Tralla, A, Johnson, C, Collins, V, Simor, AE. Screening high-risk patients for methicillin-resistant Staphylococcus aureus on admission to the hospital: is it cost effective? Infect Control Hosp Epidemiol 1999;20:473–477.Google Scholar
6.Chaix, C, Durand-Zaleski, I, Alberti, C, Brun-Buisson, C. Control of endemic methicillin-resistant Staphylococcus aureus: a cost-benefit analysis in an intensive care unit. JAMA 1999;282:1745–1751.CrossRefGoogle Scholar
7.Karchmer, TB, Durbin, LJ, Simonton, BM, Farr, BM. Cost-effectiveness of active surveillance cultures and contact/droplet precautions for control of methicillin-resistant Staphylococcus aureus. J Hosp Infect 2002;51:126–132.Google Scholar
8.Empfehlung zur Prävention und Kontrolle von Methicillin-resistent Staphylococcus aureus-Stämmen (MRSA) in Krankenhäusern und anderen medizinischen Einrichtungen: Mitteilung der Kommission für Krankenhaushygiene und Infektionsprävention am RKI. Bundesgesundheitsbl 1999;42:954–958.Google Scholar
9.Hospital Infection Control Practices Advisory Committee. Guideline for isolation precautions in hospitals: Part II. Recommendations for isolation precautions in hospitals. Am J Infect Control 1996;24:32–52.Google Scholar
10.Gesetz zur Verhütung und Bekämpfung von Infektionskrankheiten beim Menschen Infektionsschutzgesetz: IFSG. Bundesgesetzblatt Jahrgang 2000;33.Google Scholar
11.Domann, E, Hossain, H, Fussle, R, Chakraborty, T. Rapid and reliable detection of multiresistant Staphylococcus aureus (MRSA) by multiplex PCR [in German]. Dtsch Med Wochenschr 2000;125:613–618.Google Scholar
12.Vandenbroucke-Grauls, CM. Methicillin-resistant Staphylococcus aureus control in hospitals: the Dutch experience. Infect Control Hosp Epidemiol 1996;17:512–513.CrossRefGoogle ScholarPubMed
13.Minnesota Department of Health, Infectious Disease Prevention and Control Division, Facility and Provider Compliance Division. Guideline for the Management of Antimicrobial Resistant Microorganisms in Minnesota Long-Term Care Facilities. St. Paul, MN: Minnesota Department of Health; 2000. Available at www.health.state.mn.us/divs/dpc/ades/infect/guideline.htm. Accessed August 10, 2003.Google Scholar
14.Rubinovitch, B, Pittet, DI. Screening for methicillin-resistant Staphylococcus aureus in the endemic hospital: what have we learned? J Hosp Infect 2001;47:9–18.CrossRefGoogle ScholarPubMed
15.Kluytmans, J, van Belkum, A, Verbrugh, H. Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev 1997;10:505–520.CrossRefGoogle ScholarPubMed
16.Andersen, BM, Lindemann, R, Bergh, K, et al.Spread of methicillin-resistant Staphylococcus aureus in a neonatal intensive unit associated with understaf fing, overcrowding and mixing of patients. J Hosp Infect 2002;50:18–24.Google Scholar