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Effect of Targeted Surveillance for Control of Methicillin-Resistant Staphylococcus aureus in a Community Hospital System

Published online by Cambridge University Press:  21 June 2016

Timothy E. West ,
Cile Guerry ,
Mary Hiott ,
Nancy Morrow ,
Katherine Ward  and
Cassandra D. Salgado
Timothy E. West
Affiliation:
Infectious Diseases Consultants & Travel Medicine, PC, Charleston, South Carolina
Cile Guerry
Affiliation:
Department of Infection Control, Roper-St. Francis Healthcare, Charleston, South Carolina
Mary Hiott
Affiliation:
Department of Infection Control, Bon Secours St. Francis Hospital, Charleston, South Carolina
Nancy Morrow
Affiliation:
Department of Infection Control, Roper-St. Francis Healthcare, Charleston, South Carolina
Katherine Ward
Affiliation:
Department of Infection Control, Roper-St. Francis Healthcare, Charleston, South Carolina
Cassandra D. Salgado*
Affiliation:
Medical University of South Carolina, Charleston, South Carolina
*
Hospital Epidemiologist, Medical University of South Carolina, 100 Doughty Street, Suite 210 BA/IOP, Charleston, SC 29425 ([email protected])
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Abstract

Objective.

To examine the cost associated with targeted surveillance for methicillin-resistant Staphylococcus aureus (MRSA) and the effect of such surveillance on the rate of nosocomial MRSA infection in a community hospital system.

Design.

A before-and-after study comparing the rate of MRSA infection before (BES) and after (AES) the initiation of expanded surveillance. Cost-effectiveness was calculated as the difference between the cost savings associated with preventing nosocomial MRSA bacteremias and surgical site infections AES and the cost of MRSA cultures and contact isolation for patients colonized with MRSA.

Setting and Participants.

Patients in a 400-bed tertiary-care facility (Roper Hospital) and a 180-bed suburban hospital (St. Francis Hospital), both in Charleston, South Carolina.

Interventions.

Beginning in September 2001, patients were screened for MRSA colonization upon admission to the intensive care unit and weekly thereafter. In July 2002, surveillance was expanded to include targeted screening of patients admitted to general wards who were at risk of MRSA colonization. Colonized patients were placed in contact isolation.

Results.

The mean rate of nosocomial MRSA infection decreased at Roper (0.76 cases per 1,000 patient-days BES and 0.45 per 1000 patient-days AES; P = .05) and at St. Francis (0.73 cases per 1,000 patient-days BES and 0.57 cases per 1000 patient-days AES; P = .35). Surveillance was cost-effective, preventing 13 nosocomial MRSA bacteremias and 9 surgical site infections, for a savings of $1,545,762.

Conclusions.

Targeted surveillance for MRSA colonization was cost-effective and provided substantial benefits by reducing the rate of nosocomial MRSA infections in a community hospital system.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 3 , March 2006 , pp. 233 - 238
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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