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PLoS One. 2016 Feb 5;11(2):e0148175. doi: 10.1371/journal.pone.0148175. eCollection 2016.

Costs and Benefits Associated with the MRSA Search and Destroy Policy in a Hospital in the Region Kennemerland, The Netherlands.

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Department of Epidemiology and Infection Prevention, Regional Public Health Laboratory Kennemerland, Haarlem, the Netherlands.
Department of Infection Control, Kennemer Gasthuis, Haarlem, The Netherlands.
Laboratory for Microbiology and Infection Control, Amphia Hospital, Breda, and University Medical Center, Utrecht, The Netherlands.



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.


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%).


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.


Application of the MRSA S&D policy saves lives and money, although the high rate of unexpected MRSA cases is alarming.

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