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Tracking hemodialysis patients with new MRSA infections less costly than mass screening
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Routine nasal screenings in patients on hemodialysis and at high risk for MRSA in an area of low MRSA endemicity yielded low rates of the infectious disease, according to research published in Infection Control & Hospital Epidemiology.
If MRSA prevalence is low, it is unlikely that conducting twice-yearly MRSA screenings of patients on dialysis would be cost-effective, according to researchers in Switzerland.
“In an area of low [MRSA] prevalence, it would be cost saving to discontinue mass screenings and instead to concentrate on tracing contacts of newly identified MRSA-infected hemodialysis patients,” the researchers wrote.
Hiwot Mamo Gebreselassie , MD , of the department of infectious diseases, Bern University Hospital, and colleagues looked at studies assessing MRSA prevalence twice-yearly in a hemodialysis unit of a 950-bed tertiary care hospital over 10 years. Nasal swab samples were cultured on MRSA screening agar.
The researchers analyzed 20 mass screenings during the study; 415 patients had undergone at least one screening, and the average was 4.5 screenings per patient.
Collectively, there were 15 (3.6%) MRSA carriers. The first screening demonstrated the highest percentage of MRSA, with six out of 101 (6%) patients found to be carriers. New MRSA carriers were only found in seven subsequent screenings. Four screenings confirmed known carriers, and eight screenings were negative. No MRSA carriers developed bacteremia during the 10-year period.
Screening and isolation costs totaled $93,930. An alternative strategy without mass screening would cost the same as isolating index MRSA cases and contact tracing. The researchers estimated those costs at $5,382, representing a savings of $88,548.
“Future studies may help determine the most cost-effective strategy for MRSA prevention in hemodialysis patients or other high-risk populations as a function of the local prevalence,” the researchers wrote. – by Allegra Tiver
Disclosure: The researchers report no relevant financial disclosures.
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