Cost-effectiveness of rapid MRSA screening in surgical patients

Eur J Clin Microbiol Infect Dis. 2009 Nov;28(11):1291-6. doi: 10.1007/s10096-009-0778-5. Epub 2009 Aug 10.

Abstract

This study investigates the effectiveness of a same-day polymerase chain reaction (PCR) test for the rapid detection of methicillin-resistant Staphylococcus aureus (MRSA) in a general screening of patients admitted to the trauma surgery and heart surgery department in a German university hospital. A total of 442 patients were screened over a 4-month period by using a PCR assay, compared to culture methods, for specimens from the nose and throat. The MRSA carriage rate on admission was 3.85% during the study period. The PCR results of 1,680 swabs showed a sensitivity of 85% and a specificity of 99.39% for swabs from the nares and for the throat 42.11% and 98.78%, respectively. A combination of specimens from the nose and throat from the same patient led to a sensitivity of 100% with a specificity of 98.29%. Cost calculation under the circumstances of a diagnosis-related groups (DRG) payment system found that the eight MRSA-positive patients created costs of 38,472 euros, i.e. 4,809 euros per patient, facing screening costs of 36.62 euros per sample. Screening patients by using the rapid PCR assay for a combination of specimens from the nose and throat would offer a safe and cost-effective way of MRSA screening on admission.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Carrier State / diagnosis*
  • Carrier State / epidemiology
  • Cost-Benefit Analysis
  • Culture Techniques / economics
  • Culture Techniques / methods
  • Diagnosis-Related Groups / economics
  • Germany
  • Humans
  • Inpatients
  • Mass Screening / economics*
  • Mass Screening / methods
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification*
  • Molecular Diagnostic Techniques / economics
  • Molecular Diagnostic Techniques / methods
  • Nose / microbiology
  • Pharynx / microbiology
  • Polymerase Chain Reaction / economics*
  • Polymerase Chain Reaction / methods
  • Prevalence
  • Sensitivity and Specificity
  • Staphylococcal Infections / diagnosis*
  • Staphylococcal Infections / epidemiology
  • Surgery Department, Hospital / economics
  • Time Factors*