Should vascular surgery patients be screened preoperatively for methicillin-resistant Staphylococcus aureus?
نویسندگان
چکیده
BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) can cause severe infection in patients who are undergoing vascular surgical operations. Testing all vascular surgery patients preoperatively for MRSA and attempting to decolonize those who have positive results may be a strategy to prevent MRSA infection. The economic value of such a strategy has not yet been determined. METHODS We developed a decision-analytic computer simulation model to determine the economic value of using such a strategy before all vascular surgical procedures from the societal and third-party payer perspectives at different MRSA prevalence and decolonization success rates. RESULTS The model showed preoperative MRSA testing to be cost-effective (incremental cost-effectiveness ratio, <$50,000 per quality-adjusted life year) when the MRSA prevalence is > or = 0.01 and the decolonization success rate is > or = 0.25. In fact, this strategy was dominant (ie, less costly and more effective) at the following thresholds: MRSA prevalence > or = 0.01 and decolonization success rate > or = 0.5, and MRSA prevalence > or = 0.025 and decolonization success rate > or = 0.25. CONCLUSION Testing and decolonizing patients for MRSA before vascular surgery may be a cost-effective strategy over a wide range of MRSA prevalence and decolonization success rates.
منابع مشابه
بررسی شیوع کلونیزاسیون استافیلوکوک اورئوس مقاوم به متی سیلین و وانکومایسین در نازوفارنکس در بیمارستان امیراعلم، سال 1383
Background: Staphylococcus aureus is one of the most common causes of nosocomial infections with high morbidity and mortality rate. Traditionally, methicillin resistant staphylococcus aureus has been considered a major nosocomial pathogen in healthcare facilities, but in the past decade, it has been observed emerging in the community as well. Informations regarding hospital microbial colonizati...
متن کاملPredictors of Staphylococcus aureus Colonization and Results after Decolonization
Protocols for the screening and decolonization of Staphylococcus aureus prior to total joint arthroplasty (TJA) have become widely adopted. The goals of this study were to determine: (1) whether implementation of a screening protocol followed by decolonization with mupirocin/vancomycin and chlorhexidine reduces the risk of revision compared with no screening protocol (i.e., chlorhexidine alone)...
متن کاملFrequency of hospital-acquired methicillin resistant staphylococcus aureus nasal carrier patients, Kermanshah, Iran
Introduction: Methicillin resistant S. aureus nasal carriers may be acquired the bacteria from community or hospital. Hospital-acquired bacteria are antibiotic resistant and encourage the patient and his (her) family to infection. The aim of this study was to determine the frequency of hospital-acquired methicillin resistant Staphylococcus aureus nasal carrier patients. Methods: In this ...
متن کاملNasal Colonization Rate of Community and Hospital Acquired Methicillin Resistant Staphylococcus Aureus in Hospitalized Children
Background & Aims: Prevalence of community and hospital acquired methicillin-resistant Staphylococcus aureus (MRSA) infection is increasing. The primary reservoir is the anterior nares; and nasal carriage is a risk factor for infection in a variety of populations. Infection due to hospital-acquired colonization is different from community acquired in clinical manifestations and antibiotics susc...
متن کاملCommunity-acquired methicillin-resistant staphylococcus aureus: diagnosis and treatment update for plastic surgeons.
LEARNING OBJECTIVES : After studying this article, the participant should be able to: 1. Identify risk factors associated with community-acquired methicillin-resistant Staphylococcus aureus. 2. Recognize the clinical presentation of patients with community-acquired methicillin-resistant S. aureus. 3. Understand the treatment and indications for decolonization of patients who have community-acqu...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Infection control and hospital epidemiology
دوره 30 12 شماره
صفحات -
تاریخ انتشار 2009